01: Written Exam Flashcards Preview

ICM2 > 01: Written Exam > Flashcards

Flashcards in 01: Written Exam Deck (83)
Loading flashcards...
1
Q

JVD is normally (X) cm above sternal angle and (Y) cm above R atrium.

A
X = 4
Y = 9
2
Q

T/F: If angle of bed is too high, JVP increases.

A

False - angle of bed doesn’t affect JVP (only ability to see it)

3
Q

How would you examine patient for ventricular heave?

A

Ball of hand on right sternal border (at RV)

4
Q

(Diaphragm/bell) used for high-pitched sound.

A

Diaphragm

5
Q

Splitting of (S1/S2) during (inspiration/expiration) is normal and due to delay in (X).

A

S2 (pulmonic); inspiration

X = pulmonic valve closure

6
Q

Pan-systolic murmur that projects to (carotids/axilla).

A

Axilla; mitral valve regurgitation

7
Q

Aortic regurgitation murmur heard in (early/late) (systole/diastole). Which area is it heard best?

A

Early diastole

Tricuspid area (with patient sitting upright and holding exhale)

8
Q

(Standing/squatting) and valsalva (increase/decrease) thoracic pressure. This worsens which murmurs/conditions?

A

Standing; increase

  1. Mitral valve prolapse (less volume, lax chordae tendinae, flappy valve)
  2. Hypertrophic cardiomyopathy (smaller volume, more obstruction)
9
Q

(Standing/squatting) and valsalva (increase/decrease) thoracic pressure. This “improves” which murmurs/conditions?

A

Standing; increase

Aortic stenosis (less blood passes lax valve easier)

10
Q

What’s paradoxical pulse?

A

Greater than normal (3-4 mmHg) drop in systolic P during inspiration

11
Q

Paradoxical pulse may suggest which conditions? Star the most common.

A
  1. COPD*
  2. Pericardial tamponade
  3. Constrictive pericarditis
12
Q

List the scale used for measuring pulses.

A

0 (absent)
1 (diminished)
2 (normal)
3 (bounding)

13
Q

(X) and (Y) murmurs have similar characteristics, but (X) radiates to (carotids/axilla).

A
X = aortic stenosis
Y = pulmonic stenosis 

(both systolic crescendo-decrescendo)

carotids

14
Q

BMI in lbs and inches calculation.

A

703* (lbs/in^2)

15
Q

BP cuff that’s too large will read (low/high).

A

Low on small arm; high on large arm

16
Q

What does lid lag present as in a patient? It suggests (X) condition/disease.

A

Rim of sclera visible over iris when patient gazes down;

X = hyperthyroidism

17
Q

List some causes of ptosis.

A

(Eyelid droop)

  1. Horner’s (sympathetic damage)
  2. Myasthenia gravis
  3. Oculomotor n damage
18
Q

HEENT: What is the “near reaction”?

A

Constriction of pupils when gaze changes from far object to near one

19
Q

What’s anisocoria?

A

Difference in pupil size of 0.04 mm or greater

20
Q

(X)% of people have anisocoria. This is considered benign if:

A

X = 35

Pupillary reaction is normal

21
Q

What is pterygium?

A

Triangular thickening of bulbar conjunctiva over cornea

22
Q

What is arcus senilis?

A

Benign whitish lipid ring that develops around limbus (usually in elderly)

23
Q

What do you expect to see in diabetic retinopathy?

A
  1. Microaneurysms (tiny red dots)
  2. Retinal hemorrhage
  3. Neovascularization
  4. Fibrous proliferations
24
Q

Normal optic cup/disc diameter ratio:

A

Under 0.5

25
Q

Retinal SVPs (retinal spontaneous venous pulsations) are lost in (X) condition/disease.

A

X = high ICP

26
Q

How is weber test conducted?

A

Strike tuning fork and place it at center of patient head; ask if patient hears it equally in both ears

27
Q

Patient with R-sided hearing loss hears tuning fork vibrations better in R ear when you do Weber test. What kind of hearing loss?

A

Conductive

28
Q

Dullness to percussion over lung can be indicative of both (emphysema/infiltrate/pneumothorax/pleural effusion). How can you distinguish between these two?

A

Infiltrate and pleural effusion

Infiltrate will still allow breath sounds to be heard (though altered) over the area; effusion will have loss of breath sounds

29
Q

Patient with lateral shoulder pain on adduction (arm across body) but not as much with abduction likely has which problem?

A

AC joint arthropathy/arthritis

30
Q

Patient with deltoid bursitis likely has pain with (abduction/adduction).

A

Abduction

31
Q

Patient with biceps tendinitis likely has pain with (abduction/adduction).

A

Abduction

32
Q

(X)/5 grade means the patient has active movement of the muscle group without gravity, but not against gravity

A

X = 2

33
Q

T/F: PHx should be in list format and paragraphs should be avoided.

A

True

34
Q

T/F: Meds should be included in PHx.

A

False

35
Q

Which cause of fever/cough should be immediately considered in differential in a homeless patient?

A

TB - common in homeless shelters

36
Q

In patients over the age of 65 the normal visual acuity is considered to be:

A

20/25

37
Q

T/F: Medications should be recorded in generic form.

A

True

38
Q

Pt with R side hearing loss. On Rinne test, she hears sound longer through air than through bone, indicating (conductive/sensorineural) hearing loss.

A

Sensorineural

39
Q

“Transillumination” of sinuses means:

A

No thickened mucosa or secretions in sinuses

40
Q

Positive drop arm test indicates:

A

rotator cuff tear

41
Q

Greater trochanteric bursitis will likely cause patient pain on (passive/resisted) (X).

A

Resisted

X = hip abduction

42
Q

McMurray test that is positive indicates:

A

Medial posterior meniscal tear

43
Q

Depigmentation due to autoimmune attack of melanocytes:

A

Vitiligo

44
Q

Fungal infection with red ring on outside and pale area inside:

A

Tinea corporis

45
Q

Raised lesion up to 1 cm in diameter:

A

papule

46
Q

Flat lesion up to 1 cm in diameter:

A

macule

47
Q

Raised lesion 1 cm or larger:

A

plaque

48
Q

Flat lesion 1 cm or larger:

A

patch

49
Q

Loss of entire L or R field of vision is called:

A

Homonymous hemianopia

50
Q

When do you test corneal reflex

A

Coma; assessing lesions of CN V or VII

51
Q

Muscle strength scale: what would you rate 0 (the lowest)?

A

No movement of muscle at all

52
Q

Muscle strength scale: muscle flickers, but doesn’t contract/move. What is the rating?

A

1

53
Q

Muscle strength scale: movement, but not against gravity.

A

2

54
Q

Muscle strength scale: movement against external resistance, but some weakness.

A

4

55
Q

Muscle strength scale: movement against gravity, but not against resistance.

A

3

56
Q

BP: If the brachial artery is below heart level, the blood pressure reading will be (lower/higher); if the brachial artery is above heart level, the reading will be (lower/higher).

A

Higher; lower

57
Q

(X) intercostal space for needle insertion for tension pneumothorax. (Y) intercostal space for chest tube insertion.

A
X = 2nd
Y = 4th
58
Q

(X) intercostal space as a landmark for thoracentesis with needle insertion immediately (superior/inferior) to the (Y) rib.

A

X = T7-8
Superior (inferior part of ribs have neurovascular structures running there);
Y = 8th

59
Q

Asymmetric expansion occurs in large (X).

A

X = pleural effusions

60
Q

A gap between inspiratory and expiratory breath sounds suggests (X) breath sounds.

A

X = bronchial

61
Q

In recent studies, an S3 corresponds to (X), and an S4 to (Y).

A

X = an abrupt deceleration of inflow across the mitral valve

Y = increased left ventricular end diastolic stiffness (decreases compliance)

62
Q

Carotid pulse is bounding in aortic (stenosis/regurg). Upstroke of carotid pulse is delayed in aortic (stenosis/regurg).

A

Regurg; stenosis

63
Q

A palpable S2 in pulmonic area can indicate (X). And in aortic area, (Y).

A
X = pulm HT
Y = systemic HT
64
Q

Heart: Give examples of high-pitched sounds, best heard with diaphragm of steth.

A

S1, S2; aortic and mitral regurg; pericardial friction rub

65
Q

Heart: Give examples of high-pitched sounds, best heard with bell of steth.

A

S3, S4; mitral stenosis

66
Q

Expiratory splitting of S2 suggests (X).

A

X = valvular abnormality

67
Q

(Diastolic/systolic) murmurs point to valvular disease but can also be physiologic flow murmurs arising from normal heart valves

A

Systolic

68
Q

Object on XRay can have high or low (X).

A

X = density

Opaque or lucent

69
Q

Object on CT can have high or low (X).

A

X = attenuation

70
Q

Object on MR can have high or low (X).

A

X = signal

71
Q

Object on US are described as (X) if black and (Y) if white.

A
X = echo-lucent
Y = echo-genic
72
Q

T/F: In XR, CT, and MR, imaging based on density.

A

False - not in MR

73
Q

MR: imaging related to magnetic properties and distribution of (X) within tissue. For example, water has (little/lots) of (X) and fat has (little/lots) of (X).

A

X = hydrogen atoms

Lots; little

74
Q

T1-weighted MRI: (increased/decreased) signal from water, which makes it look (bright/dark). Opposite is said of T2.

A

Decreased; dark

75
Q

MR: Fat looks (bright/dark) on T1. And T2?

A

Bright on both!

Looks dark on fat saturated sequences

76
Q

MR: Cortical bone looks (bright/dark) on T1. And T2?

A

Dark on all sequences

77
Q

Ultrasound images tissues based on their ability to:

A

transmit or reflect sound

78
Q

US: (X) is the BEST sound (transmitter/reflector) and appears all black.

A

X = water

Transmitter

79
Q

Since (X) and (Y) both prevent deeper transmission of a sound beam, some parts of the body cannot be easily imaged with US. Give two examples.

A
X = bone
Y = air

Brain and lung

80
Q

Child been tugging on her right ear. On examination you notice an erythematous, bulging tympanic membrane. Diagnosis?

A

Otitis media

81
Q

(Soft/firm), (fixed/mobile) nodes are of more concerning for malignancy.

A

Firm and fixed (and large)

82
Q

Legal mandates that require use of qualified medical interpretors.

A
  1. Title VI of Civil Rights Act 1964

2. Clinton Executive order

83
Q

About (X) proportion of BMC patients considered to have limited English proficiency. And there are (Y) number of requests for interpreters per year at BMC.

A
X = 1:3
Y = 200,000