PD3- Final Flashcards
(151 cards)
1
Q
pain, temp, crude touch
A
lateral spinothalamic tract
2
Q
light/fine touch
A
anterior spinothalamic, posterior column tracts
3
Q
proprioception, vibratory sense, discriminative touch?
A
posterior column tract
4
Q
motor pathways?
A
corticospinal tract
5
Q
serial 7s test?
A
attention
6
Q
illusions and hallucinations?
A
perception
7
Q
MMSE- normal?
A
27-30
8
Q
spell world backwards
months of year forwards/backwards
series of digits
A
attention
9
Q
logic, relevance, organization, coherence
A
thought process
10
Q
delusions, obsessions, compulsion, phobias
A
thought content
11
Q
pose a simple problem
A
judgment
12
Q
quantity/rate/rhythm/volume
A
speech
13
Q
inability to speak or understand language; lesion in dominant cerebral hemisphere
A
aphasia
14
Q
difficulty in articulation; lesions of tongue and palate
A
dysarthria
15
Q
difficulty in phonation, lesions of palate and vocal cords
A
dysphonia
16
Q
difficulty speaking/comprehending
A
dysphasia
17
Q
ask pt to read, write, and name objects
A
language
18
Q
must speak in loud voice, delayed response
A
lethargic
19
Q
drowsy/somnolent, shake pt, cloudy
A
obtunded
20
Q
marked reduction in mental and physical activity, vigorous stimuli needed
A
stupor
21
Q
reflex to assess brainstem?
if that is abnormal move to? (pt is rarely conscious in this)
A
oculocephalic reflex
oculovestibular reflex
22
Q
? can be the only Sx in a stroke
A
vertigo
23
Q
wake up w/ HA or pain w/ valsalva
A
increased ICP
24
Q
intermittent jabbing pain ?
A
trigeminal neuralgia
25
OCP, amlodipine, viagra, primary pulmonary htn ?
causes of HA
26
1 sided blindness?
optic neuritis
27
optic neuritis common sign in?
MS
28
pituitary tumor?
bitemporal hemianopsia
29
>1mm difference in pupil size?
CN III compression
30
>2 mm difference pupil size?
anisocoria
31
sluggish pupil résponse?
Adie's tonic pupil
32
afferent input in affected eye, pupils fail to constrict fully
marcus gunn pupil
33
lyme dz, guillan barre, MS, ALS, tumors, syphilis, polio
palsies can be secondary to these
34
ALS, polio seen w/
hypoglossal damage
35
MCC cause of atrophy
lack of use
36
cerebellar function assesses? 4
motor, sensory, cerebellar, vestibular
37
prenatal pd?
1st 28 days of life
38
early child hood? middle?
1-4, 5-10
39
assess GA by scoring against ? and ?; name?
New Ballard or Dubowitz score, physical and neuro
40
developmental screening test - Denver II, PEDS, CDI; most used? measures ? not ?; can miss a ?
denver II, dev. attainment, intelligence, language delay
41
oral health start at ?
12 months
42
fever is ?
100.4
43
fever can be good bc?
body's way of fighting
44
APGAR- acronym? 3 points scale- 1 point (0-2 scale) for each ?
```
activity (muscle tone)- arms and legs flexed
pulse- <100
grimace- grimace
appearance- pink body/blue extremities
respiration- slow/irregular
```
45
newborn exam- first one in?
first 24 hours
46
apgar
1 min- resuscitate? depression? normal?
5 min- high risk? nl
1 min- 0-4, 5-7, 8-10
| 5 min- 0-7, 8-10
47
well child exam - do w/ in ?
2 days of birth
48
newborn most responsive ? after meals
1-2h
49
? exam last .. kids hate it
ear; do LESS invasive FIRST
50
stranger anxiety at ?
9-15 months
51
middle childhood - parents stay in exam through age?
11
52
length measurement
| <2 yo.. take length ? position
supine
53
short stature consider ? and ? dz
endocrine, GI
54
weight infants directly on scale w/out ? toddlers ?
diaper
| standing, w/ just undies
55
head circumference measured ?
first 2 yrs of life
56
newborn- 6 mo. - head is ? than chest; same size as chest at ?
2 cm larger; 6mo-2yrs
57
associated w/ macrocephaly? 4
macroencephaly, autism, hydrocephalus, fragile X
58
at birth bpm is?
| age 2?
140bpm
| ~100bpm
59
palpate ? or auscultate heart
femoral arteries
60
respirations
- newborns
- early childhood
- middle childhood
- adult rate at ?
30-60/min newborns
20-40
15-25
age 15 yo
61
rr - during ? is more accurate
sleep (in newborns)
62
observe RR for how long?
full 60s (so variable)
63
rapid resp ? w/ grunting/nasal flaring/ acc muscle use = ? or ?
>40/min, bronchiolitis, pneumonia
64
temp- ? preferrable; ? if less than 2 months- insert ? mm
ear canal, rectal temp, 2-3mm (in anal sphincter)
65
begin BP measurements at age?
2
66
acrocyanosis on ? and ? normal; BIG PROBLEM if on ? or ?
| skin NOT health determinant
face, digits
| lips, mucous membranes
67
```
cutis marmorata ('marbled skin')
typically first few mo., worse when ?
```
infant is cold (immature nerve supply to superficial capillary bv)
68
MC over butt/lumbar region; predominant in asians, mediterranean, african descent?
mongolian spots
69
fine downy hair in PREMATURE that disappear in a few weeks
lanugo
70
pinhead sized smooth white raised areas on nose, chin, forehead; erythema?
milia; NO erythema
71
acne neonatorum- papules, pustules
- from?
- MC in ?
- usually dev at ?
- tx?
maternal estrogen
males
3 weeks but can present at birth
self limiting
72
milaria rubra aka ?
- scattered vesicles on ?
- heat rash common on ?
- obstructed sweat glands
prickly heat
erythematous base
face/trunk
73
erythema toxic
- erythematous macules with ?
- scattered diffusely over ?
- etiology? tx?
```
central pinpoint vesicles
ENTIRE BODY (to diff from milaria rubra)
unknown, self limiting
```
74
small vesiculopustures over BROWN macular BASE (to differentiate from milia)
pustular melanosis
75
phys jaundice peaks on?
day 3/4
76
```
nevus flammeus (port wine stain)- persists ?; typically appear on ?, vascular birthmark consisting of superficial and deep dilated capillaries in skin
-Tx?
```
throughout life, face/extremities
| topical/intralesional c/s
77
skin exam of infants same as adult when?
after 1st year
78
post font closes at ?
2 mo
79
ant font closes at ?
4-26 mo
80
asymmetry of cranial vault?
- from lack of ? while sleeping
- asymmetry from ?
plagiocephaly
tummy time (avoid sleeping on back)
-torticollis
81
caput succedaneum
- capillary distension/extravasation of blood from ?
- usually resolve in ? w/o comp
- scalp swelling extends across ? and over suture lines
- caused by?
- vaccuum effect of ROM
- first few days
- midline
- pressure of presenting part of scalp against dilating cervix (tourniquet effect of cervix)
82
cephalohematoma
- tearing of ?
- more common w/ ?
- suspect ? if fx crosses midline
- aka ? under scalp
veins
forceps/vaccuum delivery
skull fx
water balloon
83
hydrocephaly, rickets, congenital syphilis: PE findings?
pliable/springy bones upon palpation
84
percussion- RESONANT when ? or ?
location?
sign? aka ?
hydrocephalus, abscess
junction of frontal, parietal, and temporal bones
MacEwen's sign, 'cracked pot'
85
GA appropriate?
10th-90th %ile
86
LEADING preventable cause of mental and physical birth defects in US?
FAS
87
special characteristics of FAS?
flattened cheekbones, indistinct filtrum, poor fine motor skills, lack of imagination/curiosity
88
thick/coarse hair, LARGE tongue, ? hernias ?
congenital hypothyroidism, umbilical
89
short neck, upward slanting eyes, ? crease, widely separated ?
simian, 1st and 2nd, DOWN syndrome
90
infancy, lymphad?
| childhood?
rare
| more common- viruses
91
```
VA
blinks, may regard face
fixes on objects
coordinated eye movements
eyes converge, baby reaches
acuity around 20/50
```
```
birth
1 month
2 months
3 months
12 months
```
92
blinks in response to sudden, sharp sound
acoustic blink reflex
93
infants only have ? sinuses
ethmoid
94
sinuses
maxillar at age?
sphenoid?
frontal?
4
6
6-7
95
thorax/lungs best to listen?
from front!
96
central cyanosis ALWAYS?
abnormal
97
high risk for SIDS?
>20s or <20s w/ Sx
98
? easiest to palpate but do ? in infants
brachial, FEMORAL
99
MC heart ban in infants?
PSVT and PAT
100
infants- S3? S4?
normal, uncommon
101
MC murmur in preschool?
| adolescents?
still's murmur
| pulmonary flow
102
infants:
bowel sounds?
liver extends 1-2 cm below?
HYPERactive
| right costal margin
103
male genital
- urethral meatus and foreskin fully separate until?
- 2/3 cryptoorchidism descend by ?
10 yo
| 12 months
104
infant rectal- don't check patency if ?
defecating normally
105
at birth hands are ?
clenched
106
most newborns are born ? (MS) and it will disappear at ~?
bowlegged, 18 months
107
toeing in or out of foot disappears w/ ?
| -if can't be turned out on PE?
weight bearing
| congenital abn
108
absent reflexes/retention of reflex signals ?
dev abnormality
109
rooting reflex goes away at
4 mo
110
sucking reflex goes away at
3 yrs
111
test CNXII w/ sucking/swallowing ability and tongue position w/ ?
pinch test
112
if neuro exam abn, expand to include ? 3
sensory fxn
CN
less common primitive reflexes
113
newborns ? are tactile regions
cheeks
114
exploratory mouthing begins w/ grasping and stops around
6 months
115
temp- more sensitive to ?
cold
116
lack of realization of pain can be
congenital abn
117
hearing- by D3 prefers ?
voices (over pure tones)
118
vision- prefers to see ? at 3 months
faces
119
VA is ? at 6 months
20/100
120
intermodal perception- recognizes ? in mouth by ?
shapes, 1 month
121
NORMAL: babinski positive until ?
2 yo
122
palmar grasp goes away at
3 mo
123
plantar grasp goes away at
1 yo
124
moro reflex goes away at
6 mo (flexed legs, abducted arms, open hands)
125
asymmetric tonic reflex from?
| turn head to one side w/ jaw over shoulder- same side? other?
birth to 6 mo
| arm & leg extends, other side flexes
126
stepping reflex till 4w and reappears at ?
1-2 yo
127
reflex from tapping on forehead? if blinking persists (ban)?
gabellar reflex
| Myerson's sign
128
positive support reflex from ? to ?
3/4mo till thruout life
129
turning of shoulder and trunk in direction of head; goes away at?
righting reflex, 4 mo
130
when infants head pushed DOWN, legs drop down into FLEXION?
landau reflex aka SUPERMAN pose
131
Gross Motor Skills
walk by?
run well by?
pedal tricycle/jump by?
15 mo
2 yrs
3 yrs
132
eye exam begins at ?
| refractive errors more common in?
3
| middle childhood/adolescence
133
assess mobility of TM w/ ?
pneumatic otoscope- use insufflator
134
hearing
| -under age 4? over 4?
whisper test, full acoustic screening
135
mouth/pharynx
| one tooth for ? between 6-26 mo; up to ?
each month, 20 primary teeth
136
breast exam- onset ?, first sign of?
8-13 yo, puberty (male first sign of puberty: 9-13.5)
137
liver size determined by ? spleen typically ?
percussion, palpable
138
female- pubic hair before 7 =
precocious puberty
139
MS early childhood
| normal = increased? and decreased?
lumbar concavity, thoracic convexity
140
neuro- ? not routinely tested in young children
DTR
141
baby sleeping during day and awake at night - NORMAL; usually first ?
4-8 weeks; train w/ cycled lighting, feeding schedules, dec stimulation at night
142
umbilical cord falls off at
2 weeks
143
bathe babies ?
1x/week
144
baby pooping
once every 5 days to 5 times a day
145
face car seat BACKWARDS until ? or ?
1 yr or 20 lbs
146
colic disappears at ?
3-4 months
147
after 6 mo only use pacifier when? wean pacifier and stop altogether at ?
falling asleep, 10 months
148
breast milk can store in freezer up to ? and in fridge?
3 mo, 48 hours
149
honey dang if less than
2 yrs
150
throw bottle away at ? NO NEED TO WEAN
9 months
151
irregular/unequal pupils; weak/absent reaction to light? can be from?
argyll robertson pupil
| neurosyphilis
