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Clinical Medicine I > Physical Diagnosis 2 > Flashcards

Physical Diagnosis 2 Flashcards

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1
Q

Tracheal deviation causes

A
  1. large pleural effusion,
  2. large PTX
  3. Mass
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2
Q

Cheyne Stokes Breathing

A
  1. Gradualing increasing and decreasing resps w/ periods of apnea
  2. HF, uremia, drugs, brain damage
  3. can be normal in sleeping children/elderly
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3
Q

Kussmaul Breathing

A

Hyperventlation

Metabolic acidosis

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4
Q

Biots breathing

A

irregular, unpredictable, intermittent apnea

Respiratory depression, brain damage

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5
Q

Causes of limited chest excursion

A
  1. pleural fibrosis
  2. pleural effusion
  3. lobar pneumonia
  4. pain/splinting
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6
Q

What increases tactile fremitus?

A

Pneumonia/consolidation.

Everything else decreases

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7
Q

Hyper resonance

A

Very loud, low pitch, long duration.

COPD, PTX

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8
Q

Resonant

A

loud, low pitch, long duration

Chronic bronchitis

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9
Q

Tympanic

A

Loud, high pitch, moderate duration.

Large PTX

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10
Q

Dull

A

medium, moderate pitch, moderate duration.

Pneumonia, pleural effusion

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11
Q

Flat

A

soft, high pitch, short duration

pleural effusion

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12
Q

Tracheal breath sounds

A

Insp = Exp, loud, high pitch

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13
Q

Bronchial breath sounds

A

insp < exp, loud, high pitch

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14
Q

Bronchovesicular breath sounds

A

insp = exp, moderately loud, moderate pitch

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15
Q

vesicular breath soulnds

A

insp > exp, soft, low pitch

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16
Q

Positive egophony or bronchophony indicates…

A

lung consolidation or collapse, pneumonia, atelectasis, tumors

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17
Q

Crackles indicate…

A

bronchitis, pulmonary fibrosis, CHF

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18
Q

rhonchi indicates…

A

secretions in large airways… chronic bronchitis

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19
Q

wheeze indicates

A

airflow through narrow bronchi… asthma, COPD, chronic bronchitis, bronchus obstruction

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20
Q

Pleural friction rub indicates…

A

recent URI, pneumonia

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21
Q

Mediastical crunch

A

Hamman’s sign. Crackles in sync w/ heartbeat seen w/ mediastinal emphysema

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22
Q

Percussion: dull

Breath Sounds: bronchial, crackles

+ bronchophony, egophony, whispered pectoriloquy

increased tactile fremitus

A

Pneumonia

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23
Q

Percussion: dull to flat

Breath sounds: decreased or absent

Decreased voice sounds

Decreased tactile fremitus

A

Pleural effusion

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24
Q

Percussion: hyperresonant or tympanic

Breath sounds: decreased, possible pleural rub

Voice sounds: decreased

Fremitus: decreased

A

Pneumo

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25
percussion: diffusely hyperresonant breath sounds: decreased voice sounds: decreased fremitus: decreased increased AP diameter
COPD
26
percussion: resonant, diffusely hyperresonant breath sounds: wheeze, crackles voice sounds: decreased fremitus: decreased accessory muscle use:
asthma
27
percussion: resonant breath sounds: vesicular, crackles, wheezes, rhonchi voice sounds: normal fremitus: normal
chronic bronchitis
28
Ejection click:
valve disease, dilated aorta/pulm a.
29
systolic click
mitral valve prolapse, mid-systolic
30
JVP measures..... and evaluates...
right atrium pressure, heart failure
31
Key areas of auscultation:
Aortic: 2ICS, RSB Pulmonic: 2ICS, LSB Tricuspid: 4, 5 ICS, LSB Mitral: 5th ICS, MCL (apex)
32
Accentuated S1 indicates:
tachy, fever, HTN, anemia, mitral stenosis, hyperthyroidism
33
Soft S1 indicates:
weak contraction--thick chest wall, emphysematous lung
34
Physiologic splitting of S2 is caused by...
lower right sided pressure during inspiration
35
Wide pathologic splitting of S2...
during inspiration. pulmonic stenosis, mitral regurg, r. bundle branch block
36
Fixed pathologic splitting of S2
no changes during respiration ASD, r. vent. failure
37
Paradoxcal splitting of S2
left bundle branch block
38
S3...
ventricular gallop, early diastole, rapid distension of ventricular walls. heard w/ bell at apex heart failure, anemia, volume overload of ventricle, decreased myocardial contractility
39
S4
atrial gallop, heard w/ bell at apex. resistance to ventricular filling HTD, CAD, AS, cardiomyopathy.
40
Pan/holo murmurs:
systolic tricuspid and mitral valve regurgitation
41
Crescendo-decrescendo murmurs:
systolic aortic stenosis
42
Midsystolic murmur:
ASD
43
Early diastolic, decrescendo
Aortic regurgitation
44
Mddiastolic murmur, decrescendo
Mitral and tricuspid stenosis
45
opening snap and diastolic rumble...
mitral stenosis
46
machinery like murmur
patent ductus arteriosus
47
Effect of standing or valsalva strain:
1. decreased volume in LV, decreased venous return to heart. 2. decreased BP, pulmonary vascular resistance 3. most murmurs decrease, HCM increases, prolapse of MV increases
48
Effect of squatting or valsalva release
1. increased volume in LV, increased venous return. 2. Increased BP, PVR 3. decreased HCM, decreased prolapse of MV, increased intensity of other murmors
49
Increased JVP (> 8cm)
heart failure, pulmonary HTN, increased vasc. tone, pericardial tamponade
50
Decreased JVP
blood loss, decreased vasc. tone
51
Allen test
assess patency of ulnar artery
52
Homan sign
calf pain on passive dorsiflexion of foot. can indcate DT
53
soft papules and plaques in anogenital region...
condyloma acuminata
54
painful vesicles and ulcers on erythematous base...
genital herpes
55
painless papule that erodes into a painless ulcer.
syphilitic chancre
56
dysuria and urethral discharge, inclammed meatus
urethritis due to gonoccocal, or trachomatis
57
fibrosis in tunica albuginea. painful penile curvature, ED
peyronie's disease
58
firm nodule or ulcer that doesn't heal. nontender. +/- inguinal adeonopathy
carcinoma of penis
59
soft bag of worms, developed slowly, collapse if elevated scrotum while supine
varicocele. infertility association
60
swelling that transilluminates
Hydrocele
61
painless mass above testis, smaller than hydrocele
spermatocele
62
+Prehn's sign (elevation provides releif Fever/chills hemi scrotal swelling
acute epididymitis
63
testicular tenderness and swelling complication of mumps and epididymitis
acute orchitis
64
acute onset of scrotal pain after trauma, vigorous activity pain on palpation absent cremasteric reflex
testicular torsion
65
Bright red bleading w/ defecation
internal hemorrhoid
66
tender, swollen, bluish mass at anal margin
external hemorrhoid
67
perianal erythema, palpable mass can lead to anorectal fistula
anorectal abscess
68
firm, nodular mass blood per rectum
rectal carcinoma
69
uti sxs, fever, chills tender prostate perineal or abdominal pain
acute prostatitis
70
recurrent UTI, normal prostate exam
chronic prostatitis
71
enlarged, firm nodule irrecular contour obstructive voiding sxs
carcinoma of prostate

Clinical Medicine I (25 decks)

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