Flashcards in Workbook5 Deck (113):
No identifiable underlying cause
Arise from other conditions
If headache is severe and of sudden onset
Subarachnoid hemorrhage or meningitis
Episodic headaches that peak over several hours
Migraine and Tension
New and persisting, progressively severe headaches raise concern of...
Tumor, abscess, mass lesions
Unilateral headaches found in...
Migraine and cluster headaches
Tension headaches found in...
Cluster headaches found in
Associated symptoms of nausea and vomiting associated with...
Migraines, brain tumors, subarachnoid hemorrhage
Feelings of euphoria, food cravings, fatigue, or dizziness, aura, change in vision, numbness/weakness in arm or leg associated with...
If coughing/sneezing/head position worsens headache it could be...
Pain from brain tumor, acute sinusitis
Pts. with chronic daily headaches taking symptomatic meds 2+ days per week might have...
Farsightedness (Difficulty seeing close up)
Aging vision (impaired near vision)
Nearsightedness (problems with distance)
Unilateral visual loss that is painless might suggest...
Vitreous hemorrhage from diabetes or trauma, macular degeneration, retinal detachment, retinal vein occlusion, or central retinal artery occlusion
Unilateral visual loss that is painful might suggest...
Corneal ulcer, uveitis, traumatic hyphema, acute glaucoma, optic neuritis from MS
Sudden and painless bilateral visual loss caused by...
Medications that change refraction (i.e. cholinergics, anticholinergics, and steroids)
Sudden and painful bilateral visual loss caused by...
Chemical or radiation exposures
Gradual bilateral visual loss caused by...
Cataracts, macular degeneration
Slow central visual loss caused by...
Nuclear cataract, macular degeneration
Peripheral visual loss caused by...
Advanced open-angle glaucoma
One-sided visual loss caused by...
Hemainopsia, quadrantic defects
Visual field moving specks/strands suggest...
Visual field fixed defects suggest...
Lesions in the retina or visual pathways
Flashing lights in visual field suggest...
Detachment of vitreous from retina...should have prompt eye consultation
Diplopa arises from...
Lesion in brainstem/cerebellum, weakness/paralysis of extraocular muscles
Horizontal diplopia due to palsy from CN...
III or VI
Vertial diplopia from palsy of CN...
III or IV
Diplopia in one eye with the other eye closed suggests...
Hearing loss due to...
Congenital, single gene mutations
Conductive hearing loss due to...
Problems in external or middle ear
Sensorinerual loss due to...
Problems in inner ear, cochlear nerve, connections to the brain
Having trouble understanding speech, complaining that others mumble, and noisy environments makes it worse suggests...
Noisy environments help hearing suggests...
Pain in external ear
Pain in inner ear
Ear pain associated with other symptoms of respiratory infection/referred from mouth/throat/neck suggests...
Soft wax discharge, debris from inflammation, rash in ear canal suggests...
Percieved sound with no external stimulus
Tinnitus + hearing loss + vertigo suggests...
Vertigo suggests problem in these places:
Labrynths of inner ear, peripheral lesions of CN VIII, or lesions in central pathways/nuclei in brain
Best way to ask about vertigo:
do you have feelings of being pulled to the ground or off to one side?
Drainage from the nose
Causes of rhinorrhea
Viral infections, allergic rhinitis (hay fever), vasomort rhinitis
Drainage from nose worsened by excessive use of decongestants
Symtoms of acute bacterial sinusitis
Symptoms appearing agter a URI, pain bending forward, maxillary toothache, tenderness over sinuses
Drugs that cause stuffiness
Oral contraceptives, alcohol, reserpine, guanethidine
Nasal congestion limited to one side suggests...
Deviated septum, foreign body, tumor
Bleeding from the nose
Causes of epistaxis
Trauma, inflammation, drying, crusting, tumors, foreign bodies
Fever, pharyngeal exudates, anterior lymphdenopathy, especially in the absence of cough suggests...
Streptococcal pharyngitis (strep throat)
Sore tongue results from...
Local lesions, systemic illness
Bleeding gums caused by...
Causes of chronic hoarsness
Smoking, allergy, voice abuse, hypothyroidism, chronic infections i.e. tuberculosis, tumors
Enlarged, tender lymph nodes accompany:
Intolerance to cold, decreased sweating suggests:
Palpitations and involuntary weight loss suggests:
Fine hair accompanies:
Coarse hair accompanies:
Redness and scaling of scalp may indicate:
Seborrheic dermatitis, psoriasis
Enlarged skull indicates
Hydrocephalus or Paget's disease of bone
Excessive facial hair
Hirsutism caused by
Polycystic ovary syndrome
Vision of 20/200 means...
At twenty feet, the patient can read print that a person with normal vision could read at 200 ft (larger second number = worse vision)
20/200 or less in better eye, corrected
Pt can't see temporal sides
Temporal defect in visual field of one eye, nasal defect in the other eye
Enlarged blind spot in:
Glaucoma, optic neuritis, papilledema
Inward/outward deviation of eyes or abnormal protrusion seen in
Graves' disease, ocular tumors
Eyebrow scaliness seen in
Lateral sparseness of eyebrows seen in:
Upstarting palepbral fissures seen in:
Red inflamed lid margins:
Excessive tearing from increased production of tears seen in:
Conjunctival inflammation, corneal irritation
Excessive tearing due to impaired draininge of tears seen in:
Ectropion, Nasolacrimal duct obstruction
Constriction of the puplis
Dilation of pupils
Pupillary inequality of .5 mm or less (benign if reactions are normal)
Asymmetry of corneal reflex suggests:
Deviation from normal ocular alignment
A fine, rhythmic, oscillation of the eyes
Abnormal proturstion of eyeball
Proptosis or Exophthalmos
Proptosis caused by:
Poor convergence seen in:
Reasons for dilating the eyes:
Head injury, coma, suspicion of narrow angle glaucoma
Absence of a red reflex suggests:
Opicaity of lens (cataract), detached retina, or retinoblastoma in children
Swelling of optic disc and anterior bulging of physiologic cup
Meningitis, subarachnoid hemorrhage, trauma, mass lesions
Loss of venous pulsations signifies:
Head trauma, meningitis, mass lesions, elevated intracranial pressure
Nonmalignant overgrowths in ear canals
Skin of ear canal is thickened, red, and itchy in addition to being swollen
Chronic Otis Externa
Red, bulging, ear drum indicates:
Prominent short process and prominent handle suggests:
Sound is heard in the impaired ear in:
Unilateral conductive hearing loss
Sound is heard in the good ear in:
Unilateral sensorineural hearing loss
BC= AC or BC>AC
Conductive hearing loss
Neural hearing loss
Nasal mucosa is reddened and swollen in:
Nasal mucosa is pale, bluish, or red in
Nasal polyps come from:
Ulcers result from
Nasal use of cocaine
Local sinus tenderness with pain, fever, and nasal discharge suggests
Connects lip with gingiva
Connects tongue to floor of the mouth
Swollen interdental papillae, redness of gingiva suggests:
A benign midline lump of hard palate of roof of mouth
Asymmetric protrusion of tongue suggests
Lesion of CN XII (Hypoglossal)
Soft palate fails to rise and uvula deviates to opposite side
CN X paralysis
Tender lymph nodes suggest:
Hard/fixed lymph nodes suggest:
Tracheal deviation may signify
Thorax issues such as mediastinal mass, atelectasis, opr large pneumothorax