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Boards Part II and III (Irene Gold) > General Diagnosis (Irene Gold) Part II and III > Flashcards

General Diagnosis (Irene Gold) Part II and III Flashcards

1
Q

What are the five components of a health history?

A 
Chief Complaint 
Past Health History
Personal and Social History
Review of Systems (ROS)
Present Illness
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2
Q

What six things need to be asked to the patient when asking about Present Illness?

A 
Onset
Palliative/Provoking
Quality of Pain
Radiation/Referral
Site/Setting/Severity
Timing/Temporal Factors 
 (OPQRST)
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3
Q

What is indicated if there is a sudden onset of pain?

A

Neuromuscular Problem

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4
Q

If pain has an insidious onset, what is the likely cause?

A

Cancer

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5
Q

If nothing makes that pain better or worse, what does the patient possible have?

A

Cancer

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6
Q

How are you able to tell if a patient is having a neuromuscular skeletal problem?

A

The patient is able to find relief from pain in a certain position

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7
Q

If a patient complains of no localization of pain, where is the pain very likely from?

A

Originating from an organ

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8
Q

If pain is stated to be a “throbbing pain”, what does it indicate?

A

Vascular

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9
Q

What is a descriptive word to describe a pain in the muscle?

A

Aching

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10
Q

If the patient describes the pain as “Burning” what is the likely cause of the pain?

A

Nerve

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11
Q

What kind of pain is described for a dissecting aneurism?

A

Tearing Pain

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12
Q

What questions need to be asked to the patient about past health history? (7 Things)

A

Surgeries
Hospitalizations
Illness (Serious)
Trauma

Previous Injury
Allergies
Medications

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13
Q

What five questions that need to be known from family history?

A 
Cardiovascular Disease
Diabetes
Stroke 
Cancer
Arthritis
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14
Q

What questions/categories do you need to ask about pertaining to the social/personal history of a patient? (8 Topics)

A 
Marital Status
Occupation
Diet
Exercise
Bowel/Urinary Problems
Sleep
Alcohol, Tobacco, and Drug use
Stress
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15
Q

What is the questionnaire to help determine if someone may be an alcoholic?

A

CAGE Questionnaire

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16
Q

What are the four parts of the CAGE Questionnaire?

A

C- Cutting Down (Have you ever felt the need to cut down on your drinking?)
A- Annoyed by others criticisms (Have you ever felt annoyed by criticism of your drinking?)
G- Guilty Feeling (Have you ever felt guilty about your drinking?)
E- Eye openers (Have you ever felt that you needed a drink to start your day?)

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17
Q

What is the normal oral temperature?

A

98.6 F

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18
Q

What is the normal Rectal and Tympanic temperature?

A

99.6 F

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19
Q

What is the normal Axilla temperature?

A

97.6 F

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20
Q

What is considered normal range for body temperature?

A

96-99.5 F (35-37.5 C)

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21
Q

What is the normal pulse rate of an Adult?

A

60-100 Beats/Min

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22
Q

What is the normal pulse rate for a Newborn?

A

120-160 Beats/Min

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23
Q

What is the normal pulse rate for a person of older age?

A

70-80 Beats/Min

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24
Q

What is the normal Respiration Rate of an Adult?

A

14-18 Breaths/Min

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25
Q

What is the normal Respiration Rate of a Newborn?

A

44 Breaths/Min

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26
Q

What is the normal Blood Pressure in an Adult?

A

90-120/60-80

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27
Q

Do blood pressure values increase or decrease in elderly people?

A

Increase

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28
Q

What blood pressure would indicate Hypertension?

A

140/90

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29
Q

What blood pressure would indicate Hypotension?

A

90/60

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30
Q

In what population would it be common to see an auscultatory gap?

A

Patients with hypertensive blood pressures

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31
Q

What is the definition of an Auscultatory Gap?

A

The loss and reappearance of the pulsatile sound while listening with the stethoscope during cuff deflation

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32
Q

What is being described as “low pitched sounds produced by turbulent blood flow in the arteries”?

A

Korotkoff Sounds

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33
Q

If there is a difference of 10-15 mm Hg in systolic reading, what vessels are being disturbed and what is the name of this condition?

A

Arterial Occlusion- Vessels being disturbed

Subclavian Steal- Name of the condition

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34
Q

What is the AKA for Subclavian Steal?

A

Transient Ischemic Attack (TIA)

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35
Q

From what artery is blood taken, during a Subclavian Steal?

A

Vertebral Artery

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36
Q

When the blood pressure is taken in the lower extremity how much higher will the readings be?

A

20%

Coarctation of the Aorta

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37
Q

Which test can be used to determine if a patient has Vertebrobasilar Artery Insufficiency? (6 exams)

A 
Barre-Lieou
DeKleyn's
Hallpike
Hautant's
Underberg
Maigne's
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38
Q

How do you perform the orthopedic test of: Barre-Lieou

A

Patient is seated, Doctor instructs patient to rotate the head maximally from side to side.

This is done slowly to start and then accelerated to patient tolerance

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39
Q

What does a positive Barre-Lieou test indicate?

A

Vertebrobasilar Artery Insufficiency

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40
Q

What is a positive finding of Vertebrobasilar Artery Insufficiency exams?

A

Dizziness

Light Headedness

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41
Q

How do you perform the orthopedic test of: DeKleyn’s

A

Patient is Supine. Doctor instructs patient to rotate and extend the head off the table then to turn to each side for 15-45 seconds.

Doctor can lend minimal support

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42
Q

How do you perform the orthopedic test of: Hallpike

A

Enhanced DeKleyn’s

Patient supine, head is extended off the table. Doctor offers support of the skull.

Doctor brings the head into extension, rotation and lateral flexion

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43
Q

How do you perform the orthopedic test of: Hautant’s

A

Patient is seated, arms extended forward to shoulder level with the hands supinated. Patient maintains this position for a few seconds. Patent then closes the eyes, rotates and hyperextends the neck to one side.

Repeated on opposite side

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44
Q

How do you perform the orthopedic test of: Underberg

A

Patient stands with eyes open, arms at side, feet close together. Patient closes their eyes, extends arms and supinates hands, then the patient extends and rotates head to one side. Then in this position patient is instructed to march in place.

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45
Q

How do you perform the orthopedic test of: Maigne’s

A

Patient is seated, Doctor brings had into extension and rotation

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46
Q

What clinical significance does scaly eyebrows have?

A

Seborrhea

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47
Q

In what two categories of people with you see a loss of the lateral 1/3 of the eyebrow?

A

Myxedema (AKA Hypothyroidism)

Elderly

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48
Q

What is another name for Myxedema?

A

Hypothyroidism

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49
Q

What condition is described by “sluggish pupillary reaction to light that is unilateral and caused by parasympathetic lesion of CN III”?

A

Adie’s Pupil

Similar to Argyll Robertson’s; but seen after 25 years of Syphilis

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50
Q

How would you describe Adie’s Pupil?

What age is usually affected?

A

A sluggish pupillary reaction to light that is unilateral and caused by parasympathetic lesion of CN III

Younger Age: 10-20

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51
Q

What is the description of Anisocoria?

A

Unequal pupil size

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52
Q

What are three possible cause of Anisocoria?

A

Drugs
Pathological
Trauma

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53
Q

Name the condition that is described as the following: “bilaterally small and irregular pupils that accommodate but do not react to light”?

A

Argyll Robertson’s

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54
Q

How would you describe Argyll Robertson’s pupil?

A

A bilaterally small and irregular pupils that accommodate but do not react to light

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55
Q

In what gynecological disease is Argyll Robertson’s pupil common in?

A

Syphilis

Argyll Robertson’s pupil with syphilis is called “Prostitutes Pupil”

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56
Q

What is Arroyo Sign?

A

Sluggish pupillary reaction due to hypo-adrenalism

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57
Q

What is another name for Hypo-adrenalism?

A

Addison’s Disease

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58
Q

What is the common microorganism to produce Blepharitis?

A

Staphylococcus, found on the skin

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59
Q

What condition of the eye is described: “inflammation of the eyelid”?

A

Blepharitis

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60
Q

How would you describe Blepharitis?

A

Inflammation of the eyelid

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61
Q

In what condition would you commonly see Blepharitis? (3 Conditions)

A

Seborrhea
Staph Infection
Inflammatory Process

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62
Q

What condition is “opacities seen in the lens” Also had an “Absent Red Light Reflex”?

A

Cataracts

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63
Q

In what two populations are cataracts frequently found in?

A

Diabetics

Elderly

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64
Q

What is the description of a Chalazion?

A

An infection of the meibomian gland causing a nodule which points inside the lid

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65
Q

How is the condition Corneal Arcus described?

A

Grayish opaque ring around the cornea

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66
Q

What significance does Corneal Arcus have in and elderly person?

A

No clinical problem and does not indicate anything pathological

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67
Q

If Corneal Arcus is seen in a younger (20-40 year old patient), what is a possible diagnosis?

A

Hyper cholesterolemia

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68
Q

Which vessel does the condition of Diabetic Retinopathy affect more?

A

Veins, more than arteries

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69
Q

What finding will you have with Diabetic Retinopathy? (3 Things)

A

Micro-aneurysms
Hard/Waxy Exudates
Neovascularization

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70
Q

Ectropion and Entropion are most commonly seen in what population?

A

Elderly

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71
Q

What is Ectropion?

A

Eyelid turned outward (Dry Eyes)

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72
Q

What is the name of the condition when the eyelid is turned inward?

A

Entropion

Eye Irritation from the eyelashes rubbing on the eyeball

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73
Q

How is Exophthalmosis described?

A

Lid lag/failure to cover the eyeball

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74
Q

What two conditions will often be associated with Exophthalmosis?

A

Grave’s Disease (Aka- Hyperthyroidism)
Will be seen Bilaterally

Tumor
Seen Unilaterally

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75
Q

What condition is described by “increase intraocular pressure causing cupping of the optic disc”?

A

Glaucoma

Acute Glaucoma will be painful

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76
Q

In Glaucoma what is the cup to disc ratio?

A

Less than 1:2

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77
Q

What early visual problems with a patient have leading up to Glaucoma?

A

Blurring of their vision, especially in the peripheral fields
Rings around lights

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78
Q

What is it called in a patient that had Glaucoma and has a tangential lighting of the cornea?

A

Crescent Sign

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79
Q

What is the fastest blindness seen in a patient with Glaucoma?

A

Closed Angle Glaucoma

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80
Q

What is the name given to an infection of the sebaceous gland causing a pimple or boil on the eyelid?

A

Hordoleum (sty)

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81
Q

What are the common finding of a patient with Horner’s Syndrome?

A

Ptosis
Miosis
Anhydrosis

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82
Q

Which side of the cervical sympathies are effected in Horner’s Syndrome?

A

Ipsilateral side

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83
Q

What is a common radiographic finding with Horner’s Syndrome?

A

Pancoast Tumor (Seen in the apex of the lung)

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84
Q

What are signs of Hypertensive Retinopathy? (5 Findings)

A 
Copper Wire Deformity
Silver Wire Deformity
A-V Nicking
Flame Hemorrhages
Cotton Wool Soft Exudates
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85
Q

What eye condition will have “dilated pupil with ptosis and lateral deviation”?

A

Internal Ophthalmoplegia

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86
Q

What two things will Internal Ophthalmoplegia not react to?

A

Light

Accommodation

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87
Q

What serious disease has Internal Ophthalmoplegia paired with it?

A

Multiple Sclerosis

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88
Q

What is the name of the condition that has “inflammation of the iris”?

A

Iritis/ Uveitis

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89
Q

What condition has a finding of Iritis?

A

Ankylosing Spondylitis

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90
Q

What is the most common reason for blindness in the elderly?

A

Macular Degeneration

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91
Q

What are early signs of Macular Degeneration?

A 
Central Vision Loss
Macular Drusen (Yellow deposits under the retina)
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92
Q

What is Macular Drusen?

A

Yellow deposits under the retina, seen in the condition of Macular Degeneration

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93
Q

What condition is described as “fixed and constricted pupils that react to light and accommodate”?

A

Miosis

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94
Q

What three conditions are commonly seen with Miosis?

A

Severe Brain Damage
Pilocarpine Medications
Narcotic Use

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95
Q

What is the description of Mydriasis?

A

Dilated and Fixed pupils

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96
Q

When would you most like see a patient with Mydriasis?

A

Anticholinergic Drugs (i.e. Atropine, Mushrooms, Death)

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97
Q

What is another name for a Choked Disc?

A

Papilledema

Use the rectangular slit on the Ophthalmoscope to test

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98
Q

What causes Papilledema?

A

Swelling of the optic disc due to increased intracranial pressure

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99
Q

When would you possible see Papilledema?

A

Patient with a:
Brain Tumor
Brain Hemorrhage

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100
Q

Is a sign of Papilledema, vision loss?

A

No

Vision loss is seen with Optic Neuritis

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101
Q

What is the name of the condition with “swelling around the eyes”?

A

Periorbital Edema

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102
Q

In what three conditions will you see Periorbital Edema?

A

Allergies (Most Common)
Myxedema
Nephrotic Syndrome (HEP; Hypertension, Edema, Proteinuria)

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103
Q

How would you describe a Pinquecula?

A

Yellowish Triangular NODULE in the bulbar conjunctiva, that is HARMLESS, and indicates aging

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104
Q

What condition is described as: “triangular THICKENING of the bulbar conjunctiva that grows ACROSS the cornea and is brought on by dry eyes”?

A

Pterygium

Surgery is needed

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105
Q

How is the condition of Ptosis described?

A

Drooping of the eyelid

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106
Q

What are four conditions that are common to have Ptosis found in them?

A

Horner’s Syndrome
Cranial Nerve III (Oculomotor)
Myasthenia Gravis (Bilateral)
Multiple Sclerosis

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107
Q

What disorder is described as “painless sudden onset of blindness”?

A

Retinal Detachment

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108
Q

What three signs are described leading up to Retinal Detachment?

A

Curtains closing over vision
Lighting Flashes
Floaters

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109
Q

What does the following color of sclera indicate:
White
Yellow
Blue

A

White: Normal
Yellow: Jaundice
Blue: Osteogenesis Imperfecta

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110
Q

What condition is described by: “fatty plaques on the nasal surface of the eyelids that may be normal or an indication of hypercholesterolemia”?

A

Xanthelasma

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111
Q

If you believe a patient has hypercholesterolemia, what two other conditions should you look for?

A

Xanthelasma

Other vascular problems

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112
Q

What is the clinical name for normal vision?

A

Emmetropia

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113
Q

What is the clinical word for Nearsightedness?

A

Myopia

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114
Q

What is the clinical word for Farsightedness?

A

Hyperopia

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115
Q

If a patient has decrease lens elasticity due to aging and is unable to see close up, but can see far away, they are said to have what clinical description?

A

Presbyopia

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116
Q

What four tests are carried out to check the integrity of Cranial Nerves II and III?

A
  • Direct Light Reflex
  • Consensual Light Reflex
  • Swinging Light Test (Also Looking for any eye Pathologies)
  • Accommodation
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117
Q

How is Visual Acuity tested on a patient?

A

Snellen Eye Chart

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118
Q

What cranial nerves are being checked, when Cardinal Fields of Gaze is carried out?

A

Cranial Nerves: III, IV and VI

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119
Q

What is the name of the cranial nerve IV?
What is it’s primary function?
What would a problem or lesion here look like?

A

Name- Superior Oblique
Primary Function-
Lesion-

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120
Q

What is the name of the cranial nerve VI?
What is it’s primary function?
What would a problem or lesion here look like?

A

Name- Lateral Rectus
Primary Function-
Lesion-

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121
Q

What Cranial Nerve is affected in Acoustic Neuroma?

A

CN VIII

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122
Q

What is Acoustic Neuroma and what is another name of it?

A

Benign tumor

AKA- Schwannoma

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123
Q

What are three common signs seen with Acoustic Neuroma?

A

Hearing Loss
Tinnitus
Vertigo

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124
Q

How is Acoustic Neuroma confirmed?

A

Tumor present on a CT or MRI

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125
Q

What is it called when there is a bacterial infection of the mastoid process?

A

Acute Mastoiditis

May present similarly to Purulent Otitis Media

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126
Q

What are two common signs will be seen with Acute Mastoiditis?

A

Inflammation and Palpatory tenderness over the mastoid

Hearing Loss is also commonly associated

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127
Q

What is the clinical term for “infection of the outer ear”?

A

Acute Otitis Externa

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128
Q

What is the more common name for Acute Otitis Externa?

A

Swimmer’s Ear

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129
Q

What are the signs of Acute Otitis Externa?

A

Inflammation and Pain over the outer ear

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130
Q

What is a noninvasive way to see if someone has Acute Otitis Externa?

A

Tugging on the Pinna will be painful

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131
Q

What condition is brought on by change in head position and is usually brief in it’s duration?

A

Benign Paroxysmal Positional Vertigo

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132
Q

How is Benign Paroxysmal Positional Vertigo diagnosed?

A

Orthopedic Exam: Dix-Hallpike Maneuver

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133
Q

How is the Dix-Hallpike Maneuver performed?

A

Patient rapidly moves from a seated to a supine position with head turned at 45 degrees to the left and waits 30 seconds.

Repeat this procedure on the right side if nystagmus is seen.

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134
Q

What finding indicate a positive Dix-Hallpike Maneuver?

A

Nystagmus
Nausea
Vertigo

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135
Q

If a patient has a “retraction of the tympanic membrane” what condition do they more than likely have?

A

Eustachian Tube Block

No fluid bubbles

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136
Q

What are two other names for Meniere’s Disease?

A

Central Vertigo

Endolymphatic Hydrops

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137
Q

What are the characteristics of Meniere’s Disease? (4 Possible)

A

Recurrent Prostrating Vertigo
Sensory Hearing Loss
Tinnitus (Ringing of the Ears)
Feeling a fullness in the ear

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138
Q

What condition is described as “Sensorineural hearing loss that occurs in people as they age and may be affected by genetic or acquired factors”?

A

Prebycussis

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139
Q

What is another name for Bacterial Otitis Media?

A

Purulent Otitis Media (PUS)

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140
Q

What may be a cause of Bacterial Otitis Media?

A

Bacterial or viral infection of the middle ear

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141
Q

What is the three classic findings of Bacterial Otitis Media?

A

Red tympanic membrane
Dilated blood vessels
BULGING tympanic membrane

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142
Q

What are two ways that someone can get Serous Otitis Media?

A

Effusion of the Middle ear by:

  1. Incomplete resolution of acute otitis media
  2. Obstruction of the Eustachian Tube
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143
Q

What is unique about Serous Otitis Media
AND
What does it look like clinically?

A

Unique- Chronic condition; Sucks the eardrum inward

Clinical Appearance- Fluid is an Amber color and has bubbles

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144
Q

What is the clinically term for “ringing in the ears”?

A

Tinnitus

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145
Q

How is the condition of Vertigo described?

A

Abnormal sensation of Rotatory movement

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146
Q

If someone has vertigo, what three things may they have difficulty with?

A

Difficulty with:
Gait
Balance
Navigation of the Environment

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147
Q

What is the clinical presentation of Allergic Rhinitis?

A

Nasal mucosa appears Pale/Blue and Boggy

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148
Q

How can you tell if a patient has Atrophic Rhinitis?

A

Thinning of the nasal mucosa with sclerosis, Crust formation and Foul odor

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149
Q

What condition typically will occur as a consequence of chronic inflammation of the nasal mucosa?

A

Polyps

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150
Q

If a patient has a nasal mucosa that appears red and swollen with a clear runny nose, what condition do they have?

A

Viral Rhinitis

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151
Q

What is another name for Cheilosis?

A

Angular Stomatitis

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152
Q

What condition is described by red sores at the corner of the mouth, that may be accompanied by bleeding?

A

Cheilosis AKA Angular Stomatitis

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153
Q

What may cause a patient to have Angular Stomatitis?

A

Deficiency of B2 (Riboflavin)

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154
Q

What is the clinical name for Thrush?

A

Candidiasis

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155
Q

What three populations are prone to get Candidiasis?

A

Pregnant Women
Bartenders
Diabetics

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156
Q

How is Candidiasis described?

What is a way to tell a patient has Thrush versus Leukoplakia?

A

Description: Thick white fungal patches

Thrush; will easily scrape off the tongue

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157
Q

What condition does a patient have if their tongue appears to be “Smooth and Glossy”?

A

Atrophic Glossitis

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158
Q

A deficiency of what two vitamins/minerals may cause Atrophic Glossitis?

A 
B Vitamins (B-12)
Iron
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159
Q

What populations are common to have Leukoplakia?

A

Smokers and Tobacco users

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160
Q

What is the condition of “Pre-cancerous lesions of white patches that are adherent to the surface of the tongue and not easily removed”?

A

Leukoplakia

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161
Q

What is commonly found with Leukoplakia?

A

Fordyce Spots; Yellow Spots on the Tongue

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162
Q

What clinical condition is described by “excessive production of growth hormone, beginning in middle age”?

A

Acromegaly

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163
Q

What classic characteristics will you see in a person with Acromegaly?

A

Abnormal/Enlarged Growth in:
Hands
Feet
Facial Bones

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164
Q

In a patient that has Acromegaly, where is the problem located?

A

Pituitary Tumor

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165
Q

What is the definition of Gigantism?

A

Excessive production of growth hormone prior to skeletal maturity

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166
Q

What is the most common cause of Hyperthyroidism?

A

Grave’s Disease (Autoimmune Disorder)

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167
Q

In Hyperthyroidism what hormone is:
Decreased
and
Increased

A

Decreased: Thyroid Stimulating Hormone (TSH)

Increased: Thyroid Hormones

    • T3- Triiodothyronine
    • T4- Thyroxine
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168
Q

What is another name for Hypothyroidism?

A

Myxedema

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169
Q

What causes Myxedema/Hypothyroidism?

A

Increase in Thyroid Stimulating Hormone (TSH)

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170
Q

What is the most common cause of Hypothyroidism in the United States?

A

Hashimoto’s Thyroiditis

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171
Q

What is it called when someone has congenital hypothyroidism?

A

Cretinism

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172
Q

What two problems will and patient with Cretinism have?

A

Diminished Capacities for:
Physical
Mental

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173
Q

What two conditions will you often see a Barrel Chested appearance?

A

Chronic Obstructive Pulmonary Disease (COPD)

Cystic Fibrosis

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174
Q

On an x-ray what is the ratio of AP to Lateral, to determine if a patient has a Barrel Chest?

A

1:1

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175
Q

What are two Congenital Anomalies of the chest?

A

Pectus Excavatum

Pectus Carinatum

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176
Q

What is an AKA for Pectus Excavatum?

A

Funnel Chest

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177
Q

What is an AKA for Pectus Carinatum?

A

Pigeon Chest

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178
Q

How is Pectus Excavatum clinically described?

A

Marked depression noted in the sternum (Sunken In)

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179
Q

How does Pectus Carinatum present?

A

Forward protrusion of the sternum (Like the keel of the ship)

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180
Q

How is Tachypnea classified?

A

Rapid, Shallow Breathing

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181
Q

What is the clinical term for Slow breathing?

A

Bradypnea

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182
Q

A pattern of breaths defines as follows: “Group of quick, shallow inspirations, followed by IRREGULAR periods of apnea”, is called _______________?

A

Biot’s Breathing

No Pattern to Breathing

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183
Q

What is the clinically description of Cheyne Strokes Respiration?

A

Breathing pattern characterized by alternating periods of apnea (no breathing) and hyperpnea (has pattern)

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184
Q

In what condition will you see a patient present with Cheyne Strokes Respiration?

A

Respiratory Acidosis

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185
Q

What is the name of breathing found in patients with Diabetic Acidosis?

A

Kussmaul’s

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186
Q

What kind of breathing pattern would a patient with Diabetic Acidosis present with?

A

Breaths would be rapid and shallow in the beginning, as metabolic acidosis get worse, breathing would become deep, slow, labored and gasping.

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187
Q

Patients that have Metabolic Acidosis, have breathing called:

A

“Air Hunger Breathing”

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188
Q

What condition would you commonly see Pitted Nails?

A

Psoriasis

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189
Q

What disorder does a patient have if they have, splinter hemorrhage in the nails?

A

Subacute Bacterial Endocarditis

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190
Q

A patient with transverse riding associated with acute severe disease has a condition called:

A

Beau’s Lines

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191
Q

What is the clinically name given to inflammation of the nail fold near the cuticle?

A

Paronychia

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192
Q

If a patient has clubbing of the nails, what two conditions may they have? One being an early sign, the other being later.

A

Hypoxia (Early Sign)

COPD (Late)

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193
Q

Clubbing of the nails, indicates a decrease in oxygen in the blood, what condition may this be linked to?

A

Bronchogenic Carcinoma

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194
Q

If a patient presents with a spooning appearance to their nails, what are they likely deficient in?

A

Iron, Causing Iron Deficiency Anemia

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195
Q

What is the clinical name of Spoon Nail?

A

Koilonychia

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196
Q

How do you preform Respiratory Excursion?

A

Place hands over the patients ribs and have the patient take a few deep breaths

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197
Q

When preforming Tactile Fremitus, if vibrations are increased, what is that a indication of?

A

Pneumonia- Fluid in the lung

Possible Congestive Heart Failure (CHF); Pulmonary Edema

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198
Q

What may cause Tactile Fremitus to be decreased?

A

Air:
Emphysema
Pneumothorax

Sound Barrier is Created with:
Atelectasis
Pleurisy

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199
Q

What is the term used over normal lung tissue/sounds?

A

Resonate

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200
Q

What will cause lung sounds to be hyperresonant?

A

Increase air in the chest (i.e. Emphysema, Pneumothorax)

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201
Q

If a patient presents with Pneumonia or Atelectasis, what kind of lung sound will be produced?

A

Dull

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202
Q

How is Diaphragmatic Excursion performed?

A

Doctor ask patient to exhale and hold. Doctor percusses do the back of the intercostal margins (bone will be dull) starting below the scapula, until the sound changes from resonant to dull. Doctor marks that spot. Then the patient takes a deep breath in and holds. The doctor percusses down again, marking the spot where the sound changes from resonate to dull again. Doctor will measure the distance between the two spots.

If there is LESS than 3-5 cm, patient has pneumonia or pneumothorax, use chest x-ray to diagnose.

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203
Q

What should the tracheal duration be; ratio of Inspiration versus Expiration?

A

Inspiration should be equal to expiration

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204
Q

Where should the location of the tracheal breath sounds be heard?

A

Over the Trachea

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205
Q

When comparing Inspirations versus Expirations of the Bronchial breath sounds what is the duration?

A

Expirations should be LONGER than Inspirations

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206
Q

Where is the best location to hear bronchial breath sounds?

A

Over the Manubrium

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207
Q

What is normal duration for brochovesicular breath sounds?

A

Inspiration is equal to Expiration

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208
Q

Where is the best location to hear brochovesicular breath sounds?

A

Between 1st-2nd rib Anteriorly

Between the Scapulae Posteriorly

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209
Q

Vesicular breath sounds; what is normal duration?

A

Inspiration LONGER than Expiration

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210
Q

Where is the best location to listen to Vesicular breath sounds?

A

The remaining lung field

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211
Q

What condition are Rales often associated with?

A

Bronchitis

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212
Q

A small clicking, bubbling or rattling sound, maybe described as moist, fine, dry or coarse in the lung is a description of _______?

A

Rales

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213
Q

What abnormal lung sound resembles snoring?

A

Rhonchi

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214
Q

When does a Rhonchi happen?

A

When air is blocked or becomes rough through large airways

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215
Q

When is a rale likely to be heard?

A

When air opens and closed air space

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216
Q

What condition will be see with Rhonchi?

A

Bronchiectasis

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217
Q

What type of sound and how is a Wheeze produced?

A

High pitched sound, through narrow airways

Lower Airway Expansion

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218
Q

Is a wheeze herd upon inspiration or expiration?

A

Exhalation

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219
Q

What two population will you hear wheezes in? One old and one young population.

A

Young: Asthma
Older: Emphysema

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220
Q

What is it called when you have a wheeze like sound on inspiration?

A

Stridor

Upper Respiratory Infection

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221
Q

Stridor is commonly found in children with _________?

A

Croup

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222
Q

How is stridor produced?

A

Usually a blockage of airflow

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223
Q

What is a positive finding for Bronchophony?

A

If clear, distinct sounds are heard as patient says “99”, consolidation is present

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224
Q

What is a positive finding for Egophony?

A

If you hear “AAAA” as the patient says “EEEEE”, consolidation is present

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225
Q

What is a positive finding for Pectoriloquy?

A

If the words “1,2,3” are heard clearly and distinctly, consolidation is present

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226
Q

What three Vocal Resonance test can be performed, to see if consolidation is present in the lungs?

A

Bronchophony
Egophony
Pectoriloquy

Solid substances makes sounds better, knocking on a table

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227
Q

When performing a hearing exam what is “Normal Hearing” for the Weber test?

A

Equal sound heard bilaterally

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228
Q

What is a positive finding in conduction loss, when performing Weber’s test?

A

Lateralizes to the involved ear

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229
Q

Sensorineural hearing loss is a positive finding when the Weber test is heard in which ear?

A

Sound lateralizes to the uninvolved ear

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230
Q

What is considered a positive Rinne test?

A 
Air Conduction (AC) is Greater then Bone Conduction (BC)
Normal Hearing
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231
Q

What two findings would indicated a negative Rinne test?

A 
Air Conduction (AC) is Less then Bone Conduction (BC)
or
Air Conduction (AC) is Equal to Bone Conduction (BC)

Conduction Hearing Loss

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232
Q

What finding will you have in the Rinne test, with a patient who has Sensorineural hearing loss?

A

Air Conduction (AC) will be Greater than Bone Conduction (BC), with less time in the bad ear

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233
Q

What causes Secondary Hyperparathyroidism?

A

Decreased stimulation of Thyroid Stimulating Hormone (TSH), from the Pituitary gland

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234
Q

What are four other names for a Common Migraine?

A

Sick
Vascular
Ocular
Hormonal

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235
Q

What age/time and gender does a Common Migraine usually effect?

A

Age/time- Childhood and Early Adulthood

Gender- Females

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236
Q

What are the four characteristics of a Common Migraine?

A

Photophobia
Throbbing
Worse behind one eye
Nausea and/or vomiting

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237
Q

When are three other things to know about Common Migraines?

A

Familial
Decreases frequency as the person ages
Decreases with pregnancy

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238
Q

What seven things can provoke a Common Migraine and/or a Classic Migraine?

A 
Bright light
Chocolate
Cheese
Tension
Red wine
Menstrual cycle
Hypoglycemia
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239
Q

What are six follow ups that can be done to help with Common Migraine?

A 
Dietary log
Adjust
Avoid provoking/triggering factors
Decrease stress
Massage 
FeverFu- 125QD (Drug to help decrease frequency)
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240
Q

What age/time and gender does a Classic Migraine usually effect?

A

Classic Migraine, is a Neurologically Event

Age/time- Childhood and Early Adulthood

Gender- Females

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241
Q

Is a Classic Migraine usually Unilateral or Bilateral?

A

Unilateral

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242
Q

What are the five characteristics of a Classic Migraine?

A

Aura, Prodrome-sensory changes before it comes on

```
Same as Common Migraine
Photophobia
Throbbing
Worse behind one eye
Nausea and/or vomiting
~~~

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243
Q

What age/time does a patient experience a Hypertension headache?

A

Adulthood

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244
Q

What is the common location of a Hypertension headache?

A

Occipital

Vertex

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245
Q

What are two characteristics of a Hypertension headache?

A

Throbbing

Wake up with a headache

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246
Q

What two follow ups would you do if a patient presents with a Hypertension headache?

A

Blood pressure

Lipid profile

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247
Q

What age/time and gender does a Cluster headache usually effect?

A

Age/time- Adolescents to Adulthood

Gender- Males

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248
Q

What are three common sites for a Cluster headache to show up?

A

Unilateral
Orbital
Temporal

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249
Q

What are the seven characteristics of a Cluster headache?

A

**Wake up at night with headache (Comes on after sleep)
Last 15-180 minutes
Rhinorrhea (Runny nose)
Lacrimation
Facial sweating
Red eye
Miosis
NOT aggravated by exertion

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250
Q

What are two provoking factors of a Cluster headache?

A

Alcohol
Seasonal (Allergy testing)

Headaches usually occur together in “clusters”

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251
Q

What age is effected by a Muscular tension headache?

A

Any age

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252
Q

What is the location/site of a Muscular tension headache?

A

Band like

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253
Q

What are three characteristics of a Muscular tension headache?

A

Pressure

Muscle tightness

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254
Q

What are four provoking triggers for a Muscular tension headache?

A

Fatigue
Tension
Stress
Work

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255
Q

What are two other names for Temporal Arteritis?

A

Giant cell

Polymyalgia Rheumatica

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256
Q

What age is usually effected by Temporal Arteritis?

A

Over 50

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257
Q

What site/location will you commonly see Giant Cell headaches?

A

Unilateral
Temporal
Proximal muscle pain and stiffness

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258
Q

What are the six characteristics of Temporal Arteritis?

A 
Persistent burning
Aching
Throbbing
*Scalp tenderness*
*Pain with combing of the hair*
Pain with chewing (Jaw Claudication)
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259
Q

What are the two triggers that provoke Giant Cell headaches?

A

Scalp sensitivity

Tender arteries

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260
Q

What is the follow up with a patient that has Polymyalgia Rheumatica? (3 things)

A

ESR elevated
Biopsy of arteries
Look at the amount of inflammatory drugs, can cause blindness (Medical Realm)

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261
Q

What is another name for a Cervicogenic headache?

A

Veterbrogenic headache

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262
Q

What must be done before you adjust someone with a Veterbrogenic headache?

A

Flexion and Extension Films

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263
Q

What age usually gets Cervicogenic headaches?

A

Adults

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264
Q

What is the two common site/location or a Veterbrogenic headache?

A

Occipital
Upper cervical
May have a congenital anomaly

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265
Q

What may provoke a Veterbrogenic headache?

A

Head movement

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266
Q

What are three characteristics of a Cervicogenic headache?

A

Often daily
Decrease ROM in upper cervicals and occiput
Pain in the neck that refers to the head

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267
Q

What are the follow up to Cervicogenic headaches?

A

Flexion and Extension X-rays

Adjust, best treatment

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268
Q

What are three characteristics of a Sinus headache?

A

Steady throb
Localized tenderness
Worse in the morning

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269
Q

What provokes a Sinus headache?

A

Chronic sinusitis

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270
Q

Where is a common site of pain for someone who has a Subarachnoid hemorrhage?

A

Basilar area

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271
Q

What are the four characteristics of a Subarachnoid hemorrhage?

A

Abrupt onset
Constant
Stiff neck
Excruciating pain, pain like never felt before

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272
Q

What are the two provoking factors of a Subarachnoid hemorrhage?

A

Stress

Hypertension

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273
Q

What is the follow up to a patient with a Subarachnoid Hemorrhage?

A

Call 911
High Blood Pressure
Fever

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274
Q

What are the two characteristics of a Subdural hematoma?

A

Slow bleed following and trauma

Evident days to weeks post injury

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275
Q

What provokes a Subdural hematoma?

A

Trauma/Injury

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276
Q

What is the follow up to a Subdural hematoma?

A

Send to ER

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277
Q

What is the painful site/location of a Brain tumor?

A

Any place and changes with body position

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278
Q

What are the four characteristics or a Brain tumor?

A

Onset in the morning or evening
Mild to severe pain
Throbbing
Progressively worse

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279
Q

What is the follow up to a Brain tumor?

A

MRI or CT of the brain

Refer to a Neurosurgeon

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280
Q

What is the worse time of Meningitis?

A

Bacterial

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281
Q

Where will the pain be for Meningeal Irritation?

A

Neck

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282
Q

What are the four characteristics or Meningeal Irritation?

A

Intense pain
Deep pain
Stiff neck
Pain that has never been experienced before

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283
Q

What action will provoke Meningeal Irritation?

A

Flexion of the neck

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284
Q

What follow up will be done to confirm Meningeal Irritation?

A

Cerebrospinofluid (CSF) tap

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285
Q

What two orthopedic exams will be positive if a patient has Meningeal Irritation?

A

Brudzinski

Kernig

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286
Q

When a CSF tap, is done on a patient with Meningeal Irritation, what will be the findings in Bacterial and Viral Meningitis?

A

Bacterial- Decrease Sugar

Viral- Increase Protein

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287
Q

What can provoke a Hypoglycemic headache?

A

Skipping meals

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288
Q

Who would you refer a patient to that has a Hypoglycemic headache?

A

Endocrinologist

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289
Q

What is the follow up of a patient with a Hypoglycemic headache?

A

Fasting Blood Sugar (FBS)

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290
Q

What are the two characteristics of a Post Concussive injury?

A

Loss of memory

Visual disturbances

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291
Q

What four things could provoke a Post Concussive injury?

A

Fall
Motor Vehicle Accident (MVA)
Whiplash injury
Trauma

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292
Q

What is the follow up for a patient that has a Post Concussive injury?

A

Refer to Neurologist

ER

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293
Q

In what three conditions will you have a Resonant sound on Percussion?

A

Asthma
Bronchiectasis
Bronchitis

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294
Q

In what three conditions would you have a Dull/Flat sound during Percussion?

A

Atelectasis
Pleurisy
Pneumothorax

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295
Q

What two conditions will you have a Hyperresonant sound during Percussion?

A

Emphysema

Pneumonia

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296
Q

What is a common cause of Bronchiectasis?

A

Post nasal drip

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297
Q

What side will the Trachea deviate on a Pneumothorax and Atelectasis on X-ray?

A

Pneumothorax- Opposite Side

Atelectasis- Same Side

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298
Q

What five conditions will you have a Decrease in Fremitus?

A 
Asthma
Atelectasis
Emphysema
Pleurisy
Pneumothorax
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299
Q

What condition will you have an Increase in Fremitus?

A

Pneumonia

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300
Q

What two conditions will you have a Normal Fremitus?

A

Bronchiectasis

Bronchitis

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301
Q

What breath sounds are heard with Asthma and Emphysema?

A

Wheezing

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302
Q

What breath sound is heard with Atelectasis?

A

Absent (Nothing heard)

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303
Q

What breath sound is heard with Bronchiectasis?

A

Rhonchi

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304
Q

What breath sound is heard in Bronchitis?

A

Rales

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305
Q

With Pleurisy, what breath sounds are heard?

A

Crackles (Friction Rub)

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306
Q

Are breath sounds increased or decreased with Pneumothorax?

A

Decreased

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307
Q

What breath sounds will be heard in a patient with Pneumonia?

A

Egophony (EEEE)
Brocholphony (99)
Whispered Pectoriloquy (1,2,3)
Crackles

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308
Q

What condition has consolidation of the lung?

A

Lobar Pneumonia

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309
Q

What are the three characteristics of Lobar Pneumonia?

A

Productive cough for around 10 days
Rusty Brown Sputum
Fever

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310
Q

What x-ray finding is seen with Lobar Pneumonia?

A

Silhouette Sign

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311
Q

What two populations will have Friedlander’s Pneumonia?

A

Older aged individuals

Immune-compromised

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312
Q

What are two characteristics of Friedlander’s Pneumonia?

A

Productive Cough
Currant Red Jelly Sputum Caused by Klebsiella Pneumonia

Seen frequently in Alcoholics

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313
Q

What is the common cause of Pneumocystis Carinii?

A

Yeast/Fungus

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314
Q

What population is most likely to get Pneumocystis Carinii and Cytomegalovirus?

A

AIDS patients, opportunistic infection

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315
Q

What is the common presentation of a patient with Tuberculosis? (4 Things)

A

Low grade fever
Night sweats
Productive cough
Yellow/Green Sputum

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316
Q

What X-ray finding are seen with someone with Tuberculosis?

A

Ghon lesions (small white lesions)

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317
Q

What three test will be positive in a patient with Tuberculosis?

A

Mantoux Test
Tine Test
Purified Protein Derivative

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318
Q

What is the most definitive test for Tuberculosis?

A

Sputum culture

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319
Q

What is the name of the condition that has; “ stabbing chest pain worsened by respiration, with a dry/non productive cough”?

A

Pleurisy

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320
Q

What are four ways to help determine that a patient has Pleurisy?

A

Decreased respiration excursion
Deceased tactile fremitus
Dull on Percussion
Friction rub is present

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321
Q

What orthopedic exam is positive in a patient with Pleurisy?

A

Schepelmann’s Test

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322
Q

What condition is defined as “A ruptured lung causing air to become trapped in the pleural space”?

A

Pneumothorax

Trachea goes Away

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323
Q

What two things will be deceased in Pneumothorax?

A

Chest expansion

Breath sounds

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324
Q

Who can a Pneumothorax happen to?

A

Young, tall thin, previous healthy male individuals (Spontaneous)

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325
Q

How is an Atelectasis described?

A

Collapse of the lung, usually a result of a Bronchial Obstruction due to a mucous plug

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326
Q

What condition is “Irreversible focal bronchial dilation that is present with a chronic, productive cough”?

A

Bronchiectasis

Diagnosed by: CT

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327
Q

What is another name for Chronic Bronchitis?

A

Chronic Obstructive Pulmonary Disorder (COPD)

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328
Q

What is the main cause of COPD?

A

Cigarette smoking, if the patient is not a smoker, Cigarette Smoke makes it worse

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329
Q

In a patient who has Asthma, what is happening in the lungs?

A

Bronchospasm constricting the airways

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330
Q

What triggers Type I hypersensitive Asthma?

A

Airborne allergens

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331
Q

What are two clinical presentations of a patient who has Asthma?

A

Tachycardia (Increased heart rate)

Tachypnea (Increased breathing)

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332
Q

What two microorganisms will increase with an Asthma patient?

A

IgE

Eosinophils

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333
Q

What two lab test are done to confirm Asthma?

A
  • *Curshmann’s Spirals**
  • *Charcot Laden Crystals**

(Crystals and spirals in the sputum from IgE)

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334
Q

What condition is described as “destruction of elastic pulmonary connective tissue resulting in permanent dilation of the alveoli air sacs”?

A

Emphysema

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335
Q

What is the cause of Emphysema?

A

Deficiency of Alpha 1 Anti Trypsin

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336
Q

What is Bronchogenic Carcinoma?

A

Primary malignant lung tumor, starts in bronchus of the lung

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337
Q

What population is diagnosed with Bronchogenic Carcinoma?

A

Long term smokers, 20-30 years

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338
Q

What are the four common characteristics of Bronchogenic Carcinoma?

A

Non productive cough for more than 30 days
Afebrile (No fever)
Dyspnea (Difficult breathing)
Weight loss

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339
Q

In a patient that has Costochondritis, will there be swelling?

A

No

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340
Q

Where is the pain felt in a patient with Costochondritis?

A

On the cartilage between the ribs and the sternum (Cartilage is inflamed)

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341
Q

What makes Costochondritis worse?

A

Physical activity, get worse with exercise

Deep breath

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342
Q

Where is the most likely place to palpate Costochondritis?

A

3rd, 4th, 5th costosternal articulation

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343
Q

What is another name for Herpes Zoster?

A

Shingles
Vascular lesion

Must have had chicken pox to have Shingles

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344
Q

Where is Herpes Zoster often found?

A

Painful rash, along a dermatome (Single nerve root)

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345
Q

What structures are primarily involved in Shingles?

A

Dorsal root ganglion

If cranial nerve is involved- Cranial Nerve V

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346
Q

What population is Sarcoidosis most commonly seen in?

A

African Americans in the United States

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347
Q

What is Sarcoidosis?

A

Abnormal collection of inflammatory cells (granulomas) that form an nodule

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348
Q

What two locations does Sarcoidosis most commonly appear?

A

Lungs

Lymph nodes

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349
Q

What is a cancer that if from the lymphatic system and can spread to the spleen?

A

Hodgkin’s

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350
Q

What population most commonly has Hodgkin’s?

A

Young Caucasian males

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351
Q

Is Hodgkin’s unilateral or bilateral?

A

Unilateral

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352
Q

What is the best diagnosis for Hodgkin’s?

A

Biopsy

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353
Q

What must Hodgkin’s have to be termed cancer?

A

Reed Sternberg Cells

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354
Q

What characteristics will a patient present with if they have Hodgkin’s?

A 
Fever
Night sweats
Weight loss
Intense pruritus (Release of IgE) 
Enlarged spleen
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355
Q

What appearance will a Cystic Fibrosis patient have?

A

Barrel chested, similar to COPD

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356
Q

What do the glands of a Cystic Fibrosis patient produce?

A

Sweat and/or mucus

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357
Q

What characteristics will a Cystic Fibrosis patient present with?

A

Chronic progressive cough

Frequently a fatal genetic disease, of the body’s mucus glands

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358
Q

What two places does the mucus of a Cystic Fibrosis patient accumulate?

A

Lungs

Intestine

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359
Q

What test can be done on a patient with Cystic Fibrosis?

A

Sweat test, loss of excessive amounts of salt, Salty Tears

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360
Q

What organ is insufficient in a Cystic Fibrosis patient?

A

Pancreas

Calcium Channel Insufficiencies

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361
Q

What side of the heart does Jugular Venous Pulsations measure?

A

Right

362
Q

When is it possible to have more pronounced Jugular venous pulsations?

A

When Congestive heart failure (CHF) is present and pressure is applied to the liver (Heptojugular Reflex)

363
Q

What is a “Bounding” peripheral pulse termed?

A

Pulsus Magnus

364
Q

In what four conditions will you see Pulsus Magnus?

A 
**Increase in Cardiac Output**
Exercise
Anxiety
Fever
Hyperthyroidism
365
Q

How is Pulsus Parvus defined?

A

Weak or Thready

366
Q

What three conditions would you likely see Pulsus Parvus?

A

Decrease in Stroke Volume
Hypervolemia
Aortic stenosis
Congestive heart failure (CHF)

367
Q

What pulse would be seen in Left ventricular failure?

A

Pulsus Alternans

368
Q

What peripheral pulse is defined as an “alternates in amplitude”?

A

Pulsus Alternans

369
Q

What peripheral pulse is described as “two strong systolic peaks separated by mid systolic dip”?

A

Pulsus Bisferiens

370
Q

What location is Pulsus Bisferiens felt at?

A

Carotid artery

371
Q

What two valve conditions is Pulsus Bisferiens seen?

A

Aortic Stenosis

Aortic Regurgitation

372
Q

What is the name of the peripheral pulse that has a “decrease amplitude on inspiration and increased with expiration”?

A

Pulsus Paradoxus

373
Q

How big of a change does the amplitude need to be for a positive Pulsus Paradoxus?

A

Greater than 10 mm Hg

374
Q

What four conditions will you see Pulsus Paradoxus?

A

Chronic Obstructive Pulmonary Disease (COPD)
Bronchial asthma
Emphysema
Pericardial effusion

375
Q

What is the name of the peripheral pulse that is “a jerky pulse that is rapidly increasing and then collapsing because of aortic insufficiency”?

A

Water hammer pulse

376
Q

What is the clinical term for “vibrations produced by turbulent blood flow within the heart”?

What does this cause?

A

Term- Thrills

Cause- Murmurs

377
Q

What is it called when the ventricles of the heart contract?

A

Systole

378
Q

When the ventricles are relaxed and filling this is termed what?

A

Diastole

379
Q

What causes the S1 heart sound?

A

Closure or the AV valves (Mitral and Tricuspid)

380
Q

What two valves make up the Atrioventricular valves?

A

Mitral on the Left

Tricuspid on the Right

381
Q

What to valves make up the Semilunar valves?

A

Aortic on the Left

Pulmonary on the Right

382
Q

What causes the S2 heart sound?

A

Closure of the Semilunar valves (Aortic and Pulmonary)

383
Q

The S3 heart sound is called ___________?

A

Ventricular gallop

384
Q

The S4 heart sound is called ____________?

A

Atrial gallop

385
Q

In what population is the S3 heart sound heard in?

A

Normal in:
Children
Young Adults
Athletes

386
Q

If the S3 heart sound is heard in a patient over the age of 40, what may that be an early sign for?

A

Congestive heart failure (CHF)

387
Q

Which heart sound, is “related to stiffness of the ventricular myocardium to rapid filling”?

A

S4 (Atrial gallop)

388
Q

Atrial gallop is always classified as __________?

A

Pathological

389
Q

What test is done to evaluate all of the heart valves?

A

Echocardiogram/Doppler (Ultrasound of the heart)

390
Q

What is the best place to hear the Aortic heart valve?

A

2nd intercostal space on the right at the sternal boarder

391
Q

What is the best patient position to listen to the Aortic heart valve?

A

Patient seated, leaning forward and exhaling

392
Q

Where is the Pulmonic valve best heard?

A

Left sternal boarder at the 2nd intercostal space

393
Q

Erb’s point is best heard where?

A

Left sternal boarder at the 3rd intercostal space

394
Q

What clinical significance does Erb’s point have?

A

Best place to hear murmurs

395
Q

What is the location to place the stethoscope to listen to the Tricuspid valve?

A

Left sternal boarder at the 5th intercostal space

396
Q

Which valve is best auscultated at the mid-clavicular line on the left at the 5th intercostal space?

A

Mitral valve

397
Q

What patient position is the best to listen to the Mitral valve?

A

Left lateral decubitus

398
Q

What sound will a Stenosis make when listening to the heart?

A

Snapping sound

399
Q

What does Stenosis mean?

A

The valve does not open all the way

400
Q

What sound does a Regurgitating valve make?

A

Clicking sound

401
Q

Regurgitation is defined as ____________?

A

Valve not closing all the way

402
Q

What kind of sound will a Stenosis murmur have?

A

Low pitch

403
Q

Which side of the stethoscope is used for Stenosis murmurs?

A

Bell

404
Q

What sound will a Regurgitation murmur make?

A

High pitch

405
Q

What side of the stethoscope is used when listening to Regurgitation murmurs?

A

Diaphragm

406
Q

What is the pneumonic used to help with Diastolic murmurs?

A 
ARMS and PRTS
Aortic                    Pulmonic
Regurgitation       Regurgitation
Mitral                    Tricuspid  
Stenosis               Stenosis

Opposite in Systolic Murmurs

407
Q

What congenital heart defect is described as “Failure of shunt to close between the aorta and left pulmonary artery”?

A

Patent Ductus Arteriosus

408
Q

What kind of murmur is produced when a patient has Patent Ductus Arteriosus?

A

Continuous/Machinery like

Heard in both phases of the heart cycle

409
Q

What is Tetralogy of Fallot?

A 
Congestive heart defect 
D-dextapositon/overriding of the aorta
R-right ventricular hypertrophy  
I-intraventricular septal defect   
P-pulmonic stenosis

Know exactly what each of these are

410
Q

When is the murmur of Tetralogy of Fallot heard and what condition may be present?

A

Murmur- Ejection murmur during Systole

Condition- Severe cyanosis

411
Q

What is it called when there is “constriction of the descending aorta”?

A

Coarctation of the Aorta

412
Q

Where does Coarctation of the Aorta usually take place?

A

Distal to the left subclavian

413
Q

What happens to the patient’s blood pressure if they have Coarctation of the Aorta?

A

Increased Blood pressure in the upper extremities by 20 mm Hg, when compared to the lower extremity

414
Q

What is the condition called when there is “proximal stenosis of the subclavian artery”?

A

Subclavian Steal Syndrome

415
Q

In what population do you see Subclavian Steal Syndrome?

A

Young females who faint (syncope/drop attacks) while exercising

416
Q

What is the most common cause of left sided heart failure in 35-55 year old people?

A

Hypertension

417
Q

What is the 2nd most common cause of left sided heart failure?

A

Aortic stenosis

418
Q

What are the three early signs of left sided heart failure?

A

Pulmonary edema (Fluid in the lungs)
Shortness of breath (Exertional dyspnea)
Orthopnea (Feeling of drowning when laying flat, patient is able to be in a semi recumbent position)

419
Q

Where does the fluid collect first in left sided heart failure?

A

Costophrenic angles, (Will be blurred/blunted or nonexistent on x ray)

420
Q

What is the most common cause of right sided heart failure?

A

Left sided heart failure

421
Q

What is the most common cause of Mitral stenosis?

A

Rheumatic fever

422
Q

What is the definition of Cor Pulmonale?

A

Right side of the heart fails by itself (LUNG CONDITION that causes right sided heart failure)

423
Q

If there is an increase in the right ventricle what condition is likely to be present?

A

Chronic Obstructive Pulmonary Disease (COPD)

424
Q

When right sided heart failure occurs, where is the blood back up into?

A

Superior and Inferior Vena Cava

425
Q

What eight complications does right sided heart failure lead to?

A 
Edema and fluid in the extremities 
Jugular vein distension (via Superior vena cava)
Enlargement of liver and Spleen
Positive Heptojugular reflex
Ascites (Fluid in abdomen caused by portal hypertension)
Caput medusa/ Spider angioma
Pitting Edema
Stasis dermatitis
426
Q

Will there be an increase or decrease in heart rate, when a patient has Right sided heart failure?

A

Increase

427
Q

What heart sound is heard in a patient that has Right sided heart failure?

A

S3 gallop

428
Q

What will the blood pressure of a patient with Right sided heart failure do, increase or decrease?

A

Decease

429
Q

What condition is possible if there is bilateral pitting edema?

A

Hepatomegaly

430
Q

What is “an interruption of the intima allowing blood into the vessel wall with immediate “tearing” pain”?

A

Aortic Dissection

431
Q

What three conditions are Aortic Dissection associated with?

A

Hypertension
Arteriosclerosis (Descending Aorta)
Marfan’s (Ascending Aorta)

432
Q

How is Marfan’s Syndrome defined?

A

Inherited connective tissue disorder with ventricular weakening and enlargement

433
Q

What is a common patient presentation with Marfan’s Syndrome? (4 things)

A

Tall
Long finger/limbs
Lens subluxation
Cardiovascular and Lung problems

434
Q

What is another name for Angina Pectoris?

A

Coronary Vasospasm

435
Q

During rest of activity does Angina Pectoris come on?

A

Exertion (Activity)

436
Q

When does Printzmetal Angina come on?

A

At rest

437
Q

How is Angina Pectoris relieved?

A

Vasodilators, under tongue

Usually nitroglycerin

438
Q

What may cause a myocardial infarction?

A

Atherosclerosis

439
Q

What labs will be elevated in a Myocardial infraction?

A
  1. CK-MB
  2. LDH
  3. SGOT

Lab levels decrease in the opposite order (3,2,1,)

440
Q

What condition is described as “abnormal widening that involves all 3 layers; defect in elastic-media tissues”?

A

Aneurysm

441
Q

What does the P wave on an ECG indicate?

A

Atrial depolarization

442
Q

What does the QRS complex represent on the ECG?

A

Depolarization of the ventricles.

Repolarization of the atria are hidden here

443
Q

The T wave on an ECG, represents ____________?

A

Repolarization of the ventricles

444
Q

Which wave on the ECG represents repolarization of the papillary muscles?

A

U wave

445
Q

What does an increased PR interval indicate?

A

Prolonged AV nodal delay (Primary heart block)

446
Q

If there is two P waves on and ECG before the QRS complex, this is indicative of what?

A

Weinkbochs- Block at the bundle of HIS (2nd Heart Block)

447
Q

If there is complete heart block, no ventricular contraction what part of the ECG will not be seen?

A

QRS pattern

448
Q

If the ST segment of an ECG is either enlarged or inverted what does that mean?

A

Myocardial Infraction (Acute heart failure)

449
Q

What wave will be absent in a Myocardial Infarct?

A

Q wave

450
Q

If not P wave is present what condition is present?

A

Atrial Fibrillation

451
Q

What is the proper order to perform an abdominal exam?

A 
Inspection
Auscultation 
Percussion
Light Palpation
Deep Palpation
452
Q

When there is a an early intestinal obstruction, what happens to the bowel sounds?

A

Increase in bowel sounds (Car Accident Analogy)

453
Q

There is a decrease or absent in bowel sounds when?

A

Late intestinal obstruction

454
Q

With a late intestinal obstruction what may be present?

A

Adynamic (paralytic) ileus

455
Q

What is the clinical term for “vomiting up blood”?

A

Hematemesis

456
Q

What does the term Hemoptysis mean?

A

Coughing up blood

457
Q

Blood in the stool is called ______________?

A

Hematochesia

458
Q

What test is best for testing the liver?

A

Alkaline Phosphatase

459
Q

What test is best for seeing if a patient is an alcoholic?

A

Gamma-Glutamyl Transpeptidase (GGT)

Gotta Get Tanked

460
Q

What lab is done to test Liver and Kidney?

A

Blood Urea Nitrogen (BUN)

461
Q

What will the BUN test do for each Liver and Kidney?

A

Liver- Decrease

Kidney- Increase

462
Q

What is another word for Jaundice?

A

Icterus

463
Q

What condition is classically described as “yellowing of the skin, sclera and mucus membranes”?

A

Jaundice (Can occur in any liver disorder)

464
Q

What is the most common destruction of the liver?

A

Alcoholism

465
Q

What three things can Cirrhosis of the liver cause?

A

Portal hypertension
Ascites
Esophageal varices

466
Q

If an alcoholic has, coughing, tearing of the esophageal blood vessels and hematemesis, with a rash on the palmer surface due to bile salts, what condition do they have?

A

Mallory-Weiss Syndrome

467
Q

What syndrome is described as a “Thiamin deficiency form alcoholism that leads to dementia”?

A

Wernicke Korsakoff Syndrome

468
Q

What is Beri Beri Syndrome?

A

Thiamin deficiency without alcoholism

469
Q

What is the name of the disease when “liver may be tender and enlarged but the edge remains soft and smooth”?

A

Hepatitis

470
Q

How does one contract Hepatitis A?

A

From food through oral/fecal route

Self limiting and NOT a carrier

471
Q

Which type of Hepatitis is obtained via blood transfusions?

A

Hepatitis C

472
Q

This type of Hepatitis is most common to become liver cancer?

A

Hepatitis B

473
Q

What are two ways someone get Hepatitis B?

A

Dirty needles

Sexual contact

474
Q

Which type of Hepatitis is a carrier for life and has to do with both blood and venereal diseases?

A

Hepatitis B

475
Q

What kind of cancer is the most common site for metastatic disease?

A

Liver Cancer

476
Q

What are two common findings of liver cancer?

A

Enlarged liver

Hard and irregular boarder

477
Q

What is a specific marker for Hepatocellular Carcinoma?

A

Alpha fetoprotein (Liver Cancer)

478
Q

Is Direct/Conjugated bilirubin water soluble?

A

Yes

479
Q

Under what three conditions will there be in increase in Conjugated bilirubin?

A

Duct obstruction (Gallstones)
Hepatic disease
Pancreatic cancer

480
Q

If there is an increase in the amount of direct bilirubin in the blood, it may go to the urine, what is it called?

A

Urobilinogen

481
Q

Which type of bilirubin is not water soluble; Direct (Conjugated) or Indirect (Unconjugated)?

A

Indirect (Unconjugated) Pre-hepatic

Sickle Cell Anemia, Rh- condition

482
Q

What are three conditions that will have an increase in Indirect bilirubin?

A

Hemolytic disease
Drugs
Spleen disorders

483
Q

An increase in reticulocyte count is called_________?

A

Hemolytic Anemia

484
Q

Is Hemolytic anemia pre or post hepatic?

A

Pre-Hepatic

485
Q

What is the name of the test to determine Hemolytic Anemia?

A

Coomb’s Test

486
Q

Where is the two pain points of referral for a gallbladder issue?

A

Right shoulder

Tip of the right scapula

487
Q

What is the classification of Gallbladder pain to the shoulder region?

A

Viscerosomatic

Grey Poop

488
Q

What is the most common population of patient to have Cholecystitis?

A

Females over the age of 40

Female, Forty, Fertile, Fatty Fast Food, Fatty Stool, Flatulence

489
Q

If a patient has Cholecystitis what are the four characteristics they will present with?

A

Severe right upper quadrant pain
Nausea
Vomiting
After eating a large fatty meal

490
Q

What is Murphy’s Sign?

A

Inspiration Arrest Sign

491
Q

Who would you refer a patient with Cholecystitis to?

A

Gastroenterologist

492
Q

Which two test would be ordered to confirm Cholecystitis?

A 
Diagnostic ultrasound
Oral Cholecystogram (Swallow Contrast Medium)
493
Q

What condition is defined as “Calcification that can become malignant due to chronic inflammation”?

A

Porcelain Gallbladder

494
Q

What is the location of epigastric pain?

A

Straight through the T10-T12 area like a knife

495
Q

In what condition would you see chronic pancreatitis?

A

Alcoholism

496
Q

What is the approach to be carried out for acute pancreatitis?

A

Call 911 Emergency

497
Q

What is a positive Grey Turner sign?

A

Bleeding of the flanks

498
Q

What “Sign” is present with “Periumbilical ecchymosis caused by intraperitoneal hemorrhage or seen with a ruptured ectopic pregnancy”?

A

Cullen’s Sign

499
Q

What two lab values will be increased with Pancreatitis?

A

Amylase

Lipase

500
Q

What part of the pancreas is usually effected with cancer?

A

Head of the Pancreas

501
Q

What are three signs, that a patient has pancreatic cancer?

A

Dark urine
Clay colored stool
Jaundice

502
Q

What condition is being described in the following: “condition in which the pancreas does not produce a sufficient amount of insulin to take the sugar out of the blood and transport it to the tissues of the body”?

A

Diabetes Mellitus

503
Q

If the tissues of the body do not have enough insulin to work, what will they breakdown to obtain energy?

A

Fats

504
Q

What are the classic three signs of Diabetes Mellitus?

A

Polydipsia (Increase in Thirst)
Polyphagia (Increase in Hungry)
Polyuria (Increase in Urination)

505
Q

What lab would you order for a screening of Diabetes Mellitus?

A

Fasting Blood Sugar (FBS)

506
Q

What three labs would you order to help confirm Diabetes Mellitus?

A

Glucose Tolerance Test (GTT)
Fasting Plasma Glucose (FPG)
HbA1C (Glycosylated Hemoglobin)

507
Q

In what population do you usually see Type 1 or Insulin Dependent diabetes?

A

Juvenile, under 30, usually thin

508
Q

What population is often associated with Type II or Non-Insulin Dependent diabetes?

A

Adult, over 40, usually obese

Diet choice and lack of exercise, is what causes this!!

509
Q

In the condition of Diabetes Insipidus, what structure is not functioning properly and what hormone is being decreased?

A

Structure- Posterior Pituitary Gland

Hormone- Insufficient Anti-diuretic hormone (ADH) AKA Vasopressin

510
Q

What sign will NOT show up in Diabetes Insipidus?

A

Polyphagia (Increase in Hungry)

511
Q

What is another name for Diffuse Idiopathic Skeletal Hyperostosis? (DISH)

A

Forestier’s disease

512
Q

When you see Forestier’s Disease, what is a common condition that goes along with it?

A

Diabetes, do a Fasting Blood Sugar (FBS) and/or Glucose Tolerance Test (GTT)

513
Q

What condition should be suspected if you see an air bubble around the diaphragm on an X-ray?

A

Hiatal hernia

514
Q

What is a Hiatal hernia?

A

Protrusion of the stomach above the diaphragm

515
Q

In a patient that has a hiatal hernia, what are six signs they have this condition?

A 
Tenderness in Left Upper Quadrant 
Reflux esophagitis (Acid Reflux)
Dyspepsia (Indigestion)
Pain worse when lying down
Pain worse after eating a large meal
Difficulty Breathing
516
Q

Barrett’s esophagus is a precursor to what?

A

Esophageal cancer

517
Q

What condition is caused by a sliding Hiatal hernia?

A

Reflux Esophagitis

518
Q

What four things make Reflux Esophagitis worse?

A

Lying down
Eating a large meal
Valsava’s Maneuver
Bearing down

519
Q

What two special test would you order to confirm Reflux Esophagitis?

A

X-ray

Upper GI series

520
Q

What two categories are included in peptic ulcers?

A

Gastric (Stomach)

Duodenal

521
Q

What is the causative agent for Peptic ulcers?

A

H. Pylori bacteria

522
Q

Why is pain in Peptic ulcers, “pinpoint pain”?

A

Hydrochloric acid is burning a hole in the epigastric region

523
Q

What is the appearance of vomit from a patient with a Peptic ulcer?

A

Coffee ground appearance

524
Q

Does gastric ulcers have a consistent pain pattern?

A

No

525
Q

What is the unique thing about Gastric ulcers?

A

Pain is decreased by eating

Pain comes on right after eating

526
Q

What is the most common type of peptic ulcers?

A

Duodenal

527
Q

When does the pain of a duodenal ulcer occur?

A

Two hours after eating

528
Q

What kind of stool is found in a patient that has a duodenal ulcer?

A

Black/tarry stool

529
Q

What is the confirmatory test done, looking for occult blood in the stool, common in patients with duodenal ulcers?

A

Guaiac test

530
Q

What condition is seen often in males and first time mothers and described as “projectile vomiting in a newborn”?

A

Pyloric Stenosis

String Sign on x-ray: palpable node in the epigastric area

531
Q

What location of the stomach is the most common for gastric carcinoma?

A

Lesser curvature

532
Q

What is it called when the left supraclavicular lymph node is involved?

A

Virchow’s node

533
Q

What is the most common cause of Mononucleosis?

A

Epstein Barr Virus

534
Q

What age is most likely to have Mononucleosis?

A

Young adults (18-25)

535
Q

What is the name of the atypical lymphocytes found in the blood of patients with Mononucleosis?

A

Downey Cells

536
Q

What are the symptoms of Mononucleosis? (5 symptoms)

A 
Similar to the flu
Fever
Headache
Fatigue
Splenomegaly
Lymphadenopathy in cervical region
537
Q

What condition is called “Marble Bone”?

A

Osteopetrosis

538
Q

What two organs become enlarged in Osteopetrosis?

A

Liver

Spleen

539
Q

Where is the referral pain of the small intestine to?

A

Periumbilical region

540
Q

What is another name for Regional Ileitis?

A

Crohn’s Disease

541
Q

Where is Crohn’s disease located?

A

Right side of the intestine

542
Q

What disease is described as a nonspecific inflammatory disorder that affects the distal ileum and colon?

A

Regional Ileitis

543
Q

Patient’s that have Crohn’s disease, will have what three symptoms?

A 
Pain in Right Lower Quadrant (RLQ)
Chronic diarrhea (Usually bloody)
Cobblestone appearance on Sigmoidoscopy
544
Q

Regional Ileitis leads to malabsorption of what vitamin?

A

B 12

545
Q

How is Crohn’s disease confirmed? What is a finding on the test?

A

Sigmoidoscopy, Skip lesions will be present

546
Q

What can cause Regional Ileitis?

A

Non-Tropical Sprue/Celiac Sprue (Gluten Allergy)

547
Q

Where is Ulcerative Colitis located?

A

Left side of the intestine

548
Q

In what two parts of the intestine is Ulcerative Colitis most commonly found?

A

Colon

Rectum

549
Q

What is the major indicator of Ulcerative Colitis?

A

Bloody Diarrhea

550
Q

How is Ulcerative Colitis diagnosed?

A

Sigmoidoscopy

551
Q

What is another name for Irritable Bowel Syndrome?

A

Spastic Colon

552
Q

What disorder has “variable degrees of constipation and diarrhea in response to stress”?

A

Irritable Bowel Syndrome

553
Q

What gender more commonly has Spastic Colon?

A

Females

554
Q

What age, gender,symptom is it common to see Diverticulitis?

A

Over the age of 50, Female with a Fever

555
Q

What causes someone to get Diverticulitis?

A

Inadequate fiber in the diet

556
Q

What condition is described as “Chronic constipation which causes small out pouchings within the colon that become infected?

A

Diverticulitis

557
Q

Where is the pain in a patient that has Diverticulitis

A

Lower Left Quadrant (LLQ)

558
Q

What is Meckel’s Diverticulitis?

A

Out pouching of the Ilium

559
Q

If a patient has an appendicitis, where should they be referred to?

A

ER

560
Q

What special test can be done, to confirm and Appendicitis?

A

CT

561
Q

What four (orthopedic) tests will be positive in a patient that has an Appendicitis?

A

Rebound Tenderness (Peritonitis)
Rovsing’s Sign
Psoas Sign
Obturator Sign

562
Q

What is the name of the test that is done to diagnosis an Appendicitis and what does it indicated?

A

Test name- Shilling Shift

Indicates- Increase in White Blood Cells (WBC)

563
Q

What four symptoms will a patient with an appendicitis present with?

A

Fever
Nausea
Vomiting
Anorexia

564
Q

Where will the pain be present at in a patient’s abdominal region if they have an appendicitis?

A

Dull Periumbilical region or epigastric pain that radiates to the lower right quadrant (LRQ) (McBurney’s Point)

565
Q

What are the six characteristics of Cushing’s Disease?

A 
Moon face/ "pie face"
Buffalo hump
Pendulous abdomen with purple striae
Hirsuitsm (Male hair growth pattern usually on women)
Weakness
Hypertension
566
Q

What causes Addison’s Disease?

A

Decrease in aldosterone

567
Q

What are the two cause of Cushing’s Disease?

A

Increase production of adrenal cortex hormone

Long standing Cortical Steroid use

568
Q

What are two other names for Cushing’s Disease?

A

Hyperadrenalism

Hypercortisolism

569
Q

What are two other names for Addison’s Disease?

A

Hypoadreanalism

Hypocortisolism

570
Q

In increase in what hormone will cause melanin deposition in a person with Addison’s Disease?

A

Adrenocorticotropic Hormone (ACTH)

571
Q

What eight signs/symptoms will a person with Addison’s Disease present with?

A 
*Decreased blood pressure*
Thin
Weakness
Fatigue
Lethargy
Nausea
Vomiting
Hair loss
572
Q

What is it called when there is a tumor or the Adrenal Medulla?

A

Pheochromocytoma

Grey Cell Tumor

573
Q

If a person has an increase in ACTH, (Addison’s Disease)where will the hyperpigmentation show up?

A

Mouth

Face

574
Q

In the condition of Pheochromocytoma what is increased?

A

Catecholamine

Epinephrine and Norepinephrine

575
Q

What condition has a similar appearance to hyperthyroidism?

A

Pheochromocytoma

576
Q

What is the name of the condition that produces EXTREME hypertension?

A

Pheochromocytoma

Diastolic number if over 100

577
Q

What would you refer a patient that you think has a Pheochromocytoma?

A

ER (Medical Emergency)

578
Q

What condition is has an increase of calcium made in the body?

A

Nephrolithiasis

579
Q

What are the three “things” made of calcium in the condition of Nephrolithiasis?

A

Calcium oxalates (Most Common)
Calcium urates
Calcium phosphates

580
Q

Where will the pain be located in a patient with Nephrolithiasis?

A

Flank pain described as writhing

581
Q

What orthopedic test will be positive in a patient with Nephrolithiasis?

A

Murphy’s Test (Kidney Punch)

582
Q

What four test will be increased in a patient with Nephrolithiasis?

A

Blood Urea Nitrogen (BUN)
Uric acid
Creatinine clearance
Kidney, Ureter, Bladder (KUB) study

583
Q

What is the most specific test for Nephrolithiasis?

A

Creatinine clearance

584
Q

What is always one positive finding in Nephrolithiasis?

A

Blood will be found in the urine

585
Q

What can Hydronephrosis cause?

A

Staghorn calculi

586
Q

In a patient with Nephrolithiasis, if they take in Vitamin C what will that lead to?

A

Increase in kidney stones

587
Q

What is another name for Acute Glomerulonephritis?

A

Nephritic Syndrome

588
Q

What causes Acute Glomerulonephritis?

A

Group A hemolytic strep, will have a Positive ASO Titer test

589
Q

What are the findings in Nephritic syndrome?

A

Red blood cells (RBC) cast in the urine with small amount of protein

590
Q

What are the three classic signs in Nephrotic syndrome?

A

HEP

Hypertension
Edema
Proteinuria (Massive)

591
Q

What is Nephrotic syndrome in a pregnant woman called?

A

Pre-eclampsia

592
Q

What is the definition of Eclampsia?

A

Nephritic syndrome with convulsions during pregnancy

593
Q

What kind of cast are found in the urine in a patient that has Nephrotic syndrome?

A

Waxy or fatty

594
Q

How does someone get Polynephritis?

A

E-coli infection for a Urinary Tract Infection (UTI)

595
Q

In the condition of Polynephritis what kind of cast will be found in the urine?

A

White Blood Cell (WBC) cast

596
Q

What condition is described as “Inherited disorder with many bilateral renal cysts that increase renal size but reduce function of the renal tissue”?

A

Polycystic Kidney Disease

597
Q

What three findings will be present in a person who has a Renal Carcinoma?

A

Bleeding
Flank pain
Enlarged mass

598
Q

What is found in the urine of a person with Urethritis?

A

Nitrites

599
Q

What is the most common cause of Urethritis in females?

A

E. Coli

600
Q

What are the two diagnosis of Urethritis?

What causes each classification?

A

Gonococcal (Caused by Gonorrhea) More often seen in Males

Non-Gonococcal (Caused by Chlamydia)

601
Q

What two areas will the patient with Cystitis have pain?

A

Suprapubic

Low back pain

602
Q

How is Cystitis defined?

A 
Noninfectious bladder inflammation 
Urination will be: 
Burning
Pain (During and after urination)
Frequent urination with incontinence
603
Q

What is another name for a Wilm’s tumor?

A

Nephroblastoma

604
Q

What condition is seen in a younger person, with abdominal mass and hematuria?

A

Nephroblastoma

605
Q

What is a Nephroblastoma?

A

Malignant tumor of the kidney

606
Q

What is the clinical term for an “Overactive Bladder”?

A

Urinary Incontinence; Neurological Problem

607
Q

What is the most common cause of Urinary Incontinence?

A

Stress

608
Q

How is Stress Incontinence define?

A

Increase in Abdominal pressure

i.e.: Exercise, Cough, Sneeze, Laugh

609
Q

What causes Urinary Incontinence?

A

Weakness in the pelvic floor muscles

610
Q

What exercises may be given to a patient with an Overactive Bladder?

A

Kegal Exercises

611
Q

What type of urinary incontinence has “the inability to completely empty your bladder when you urinate”?

A

Overflow

612
Q

What is a common result of an Overflow bladder? (Urinary Incontinence)

A

Constant flow

Frequent dribble

613
Q

What is a condition that is common in people with an Overflowing bladder?

A

Prostate Enlargement

614
Q

What type of urinary incontinence is most commonly seen in “older adults with arthritis, Parkinson’s and Alzheimer’s”?

A

Functional

615
Q

What is the most common type of hernia?

What is the location of this type of hernia?

A

Indirect Inguinal Hernia

Location-Lateral and Inferior to the Epigastric Vessels

616
Q

What population do you see Indirect Inguinal hernias in?

A

Children and young adults

617
Q

How is an Indirect Inguinal Hernia described?

A

Passes down the inguinal canal and exits the external inguinal ring and into the scrotum

618
Q

Where does a Direct Inguinal hernia exit from?

What is the Location of a Direct Inguinal Hernia?

A

External inguinal ring, does not pass through the inguinal canal

Location-Medial and Inferior to the Epigastric Vessels

619
Q

What two things usually cause a Direct Inguinal hernia?

A

Obesity

Heavy lifting

620
Q

During what two times is a Direct Inguinal hernia often felt?

A

When the patient:
Coughs
Bears down

621
Q

What age is a Direct Inguinal hernia often seen?

A

Older, over the age of 40

622
Q

Where is a Femoral Hernia found?

A

Bulge lateral and inferior to the external inguinal ring at the site of the femoral pulse

623
Q

Is a femoral hernia, classified as a inguinal hernia?

A

No

624
Q

What condition is “Abnormal endometrial tissue found outside of it’s normal location”?

A

Endometriosis

625
Q

Where is endometriosis most commonly found?

A

Ovaries

626
Q

What are five signs of Endometriosis?

A 
Abdominal pain
Back pain
Severe menorrhagia
Painful intercourse (Dyspareunia) 
Possible infertility
627
Q

What is the most common reason for a hysterectomy?

A

Uterine fibroids

628
Q

What condition is described as “Benign uterine tumor of smooth muscle origin”?

A

Uterine fibroids

629
Q

What are three symptoms present with Uterine Fibroids?

A

Heavy menstrual bleeding
Pelvic pain
Painful intercourse

630
Q

How will the uterus feel in a patient with Uterine Fibroids?

A

Painless nodules that are irregular and firm

631
Q

What condition is an “infection of the upper female genital tract”?

A

Pelvic Inflammatory Disease

632
Q

Which two STD’s are the most common cause of Pelvic Inflammatory Disease?

A

Gonorrhea

Chlamydia

633
Q

What other condition is often seen with Pelvic Inflammatory Disease?

A

Salpingitis (Inflammation of the fallopian tubes)

634
Q

What condition is described as a “pregnancy in which implantation has happened outside of the endometrial cavity”?

A

Ectopic pregnancy

635
Q

What three signs will be present is a patient with an Ectopic pregnancy?

A

Spotting
Decreased blood pressure
Decrease in Human Chorionic Gonadotropin (HCG)

636
Q

What is the common cause for the first and second reason for an Ectopic Pregnancy?

A

First- Prior Gonococcal infection

Second- Intrauterine Device (IUD)

637
Q

What are four common finding in normal pregnancy?

A

Increase in Human Chorionic Gonadotropin (HCG)
Nausea
Weight gain
Breast tenderness

638
Q

What condition will have a very high level of Human Chorionic Gonadotropin (HCG)?

A

Hydatiform Mole

639
Q

What is the condition that is described as “A non-viable embryo which develops in the placenta and presents with all the signs of pregnancy”?

A

Hydatiform Mole

640
Q

What is the name of the condition that is “A malignancy of the placenta due to abnormal epithelium”?

A

Choriocarcinoma

641
Q

What condition is found in young women, that have Multiple, round, freely movable masses that can be palpated?

A

Fibrocystic Breast Disease

Lumpy Bumpy Breast around menses

642
Q

What make Fibrocystic Breast Disease worse?

A

Caffeine
Ovulation
Menses

643
Q

In what population is Fibrocystic Breast Disease commonly seen in?

A

Overweight Diabetics

644
Q

What is the most common benign breast tumor?

A

Fibroadenoma

645
Q

What age is Fibroadenoma usually seen in?

A

Less than 30

646
Q

What are three things to know about Fibroadenoma?

A

Non tender
Singular lesion
Unilateral 75% of the time

647
Q

What is the 2nd most common cause of death in women?

A

Breast cancer

648
Q

What is the most common location of breast cancer?

A

Upper/outer quadrant (Axillary area, tail of Spence)

649
Q

What are the four common findings associated with breast cancer?

A

Nipple retraction
Dimpling (Paget’s Disease of the breast)
Bleeding
Orange peel appearance

650
Q

Where will breast cancer metastasis to?

What kind of appearance does breast cancer have on bone?

A

Metastasis- Axilla via lymphatic system

Appearance- Lytic (Metastases from the Lymph vessels)

651
Q

What is it called when there is “Tortuous dilation of the spermatic veins”?

A

Varicocele

652
Q

When will the pain from Varicocele diminish?

A

Standing

Supine

653
Q

What is a common name for Varicocele?

A

“Bag of Worms”

654
Q

What condition is “A fluid filled mass in the epididymis”?

A

Spermatocele

655
Q

Is a Spermatocele and Hydrocele transiluminatable?

A

Yes, it’s fluid filled

656
Q

Where is a Spermatocele located?

A

Superior and posterior to the testicle

657
Q

What are three characteristics of a Spermatocele?

A

Painless
Moveable
Pea sized lump

658
Q

What is a Hydrocele?

A

Excessive accumulation of water in the testicles

659
Q

What are four characteristics of a Hydrocele?

A

Swollen
Painless
Heavy
Tight scrotum

660
Q

How is a Hydrocele able to be distinguished from a scrotal hernia?

A

Being able to palpate about the mass, indicates its a Hydrocele

661
Q

How does a patient get Epididymitis?

A

Consequence of an STD

662
Q

What is a positive finding of a Epididymitis?

A

Enlarged tender scrotum

663
Q

What is the most common type of cancer found in men aged 20-34?

A

Testicular cancer

664
Q

What is the most common type of testicular cancer?

A

Seminoma

665
Q

Is testicular painful and/or transiluminatable?

A

No

666
Q

What condition is “Enlarged, Non tender, Firm, Smooth, and has not Median Sulcus”?

A

Benign Prostatic Hyperplasia

667
Q

What condition happens in younger men from the venereal disease of Gonorrhea?

A

Prostatitis

668
Q

What are the four characteristics of Prostatitis?

A

Boggy
Soft
Enlarged
Tender; Painful

669
Q

What is one complication of Prostatitis?

A

Urinary problems, increased urgency

670
Q

What does Prostatic Carcinoma almost always look like/be associated with on x-ray?

A

Blastic Mets- Blood

671
Q

Where is the most common place for Prostatic Carcinoma to metastasize to?

A

Lumbar spine via Batson’s plexus

672
Q

What are the finding of Prostatic Carcinoma?

A

Hard Posterior lobe
Nodular
Painless
Enlarged

673
Q

What is the skin temperature in an arterial problem?

A

Cool

674
Q

What color is the skin in an arterial issue?

A

Pale or Blue

675
Q

What kind of pulse is found in a patient that has an arterial issue?

A

Weak or absent

676
Q

What two things will be present in a patient with an arterial problem?

A

Numbness

Raynaud’s Phenomenon

677
Q

Is there swelling in an arterial issue?

A

Not usually

678
Q

Will and venous or arterial issue have thin/shiny skin?

A

Arterial (Think about wrapping a rubber band around your finger, for all Arterial signs and symptoms)

679
Q

What is the skin temperature of a patient with a venous problem?

A

Warm

Venous problem, think of a Deep Vein Thrombosis (DVT) in the femoral vein

680
Q

In a patient that has a venous issue what two categories will be Normal?

A

Skin color

Pulse

681
Q

Will numbness and Raynaud’s Phenomenon be absent or present in a patient with a venous issue?

A

Absent

682
Q

If a patient has a venous issue what two things will be present?

A

Swelling

Valve incompetence

683
Q

What kind of tropic changes would you expect to see in a venous issue?

A

Stasis Dermatitis

684
Q

What type of claudication is predictable?

A

Vascular

685
Q

In what position would a patient with Neurogenic claudication find relief?

A

Flexed, this is a position related condition

686
Q

What type of claudication always has relief at rest?

A

Vascular

687
Q

What are three common cause of Neurogenic Claudication?

A

DJD- thin disc, overriding of the facets

Spinal Canal stenosis

688
Q

What two causes will lead to Vascular Claudication?

A

Arteriosclerosis
Buerger’s

Stoop Test- will decrease pain (Flexed Position)

689
Q

How is the claudication test performed?

A

Patient walks at a rate of 120 steps/min for 1 minute

690
Q

What is a positive finding for the claudication test?

A

Pain in the claves

691
Q

What does the Bicycle test confirm?

A

Pain in the calves, vascular Claudication

692
Q

What is another name for Buerger’s?

A

Thromboangitis Obliterans

693
Q

How do you test for Buerger’s?

A

Claudication time

694
Q

What is the population that is usually effected with Thromboangitis Obliterans?

A

Males 20-40 years old

Excessive tobacco/smoking use

695
Q

What three other symptoms is Buerger’s associated with?

A

Intermittent vascular claudication
Non-healing ulcers
Gangrene (Amputation)

696
Q

What two populations and what age are often seen with Varicose veins?

A

Population:
Pregnant women
Overweight adults

Age: Older than 20 years old

697
Q

What three symptoms are present with Deep Vein Thrombosis?

A

Tenderness
Edema
Pain

698
Q

What orthopedic test is done to diagnosis Deep Vein Thrombosis?

A

Homan’s test

699
Q

How is Homan’s test performed?

A

Patient is supine with leg extended while the doctor raises the leg off the table to a 45 degree angle, dorsiflex the foot and squeeze the calf

700
Q

What is a positive finding to Homan’s test?

A

Pain in the calf

701
Q

What labs can be ordered to help diagnosis Deep Vein Thrombosis?

A

D-Dimer

Complete Blood Count (CBC), Thrombocyte count

702
Q

Who often has Raynaud’s?

A

Females

703
Q

What three other conditions are seen with Raynaud’s?

A

Buerger’s
Collagen Disease
Scleroderma

704
Q

What are three triggers of Raynaud’s Phenomena?

A

Cold
Stress
Emotion

705
Q

What orthopedic exam can be done to diagnosis Raynaud’s/

A

Allen’s Test

706
Q

What five other signs are present with Raynaud’s?

A 
Arterial spasms
**Triphasic color changes (White, Blue, Red)**
Finger tip ulcers
Cold sensitivity
Gangrene
707
Q

What is the clinical term for a pinpoint hemorrhage?

A

Petechia

708
Q

What condition is described as “Blockage of an artery in the lung by a substance that has come from somewhere else in the body via the bloodstream”?

A

Pulmonary Embolism

709
Q

What is the main cause of a Pulmonary Embolism?

A

Thrombus (blood clot) from the veins of the legs

710
Q

What are the three symptoms often associated with a Pulmonary Embolism?

A

Difficulty breathing
Chest pain on inspiration
Palpitations

711
Q

What are two increased risk of someone with Pulmonary Embolism?

A

Flying
Prolonged bed rest

**(Both will lead to Deep Vein Thrombosis (DVT))

712
Q

What condition is described as “small superficial dilated blood vessels”?

A

Telangiectasia

713
Q

What is the common location of Telangiectasia?

A

Around the:
Nose
Cheeks
Chin

714
Q

What are the two other names for Reflex Sympathetic Dystrophy?

A

Complex Regional Pain Syndrome

Sudeck’s Atrophy

715
Q

What is the treatment for Reflex Sympathetic Dystrophy?

A

Sympathetic nerve block

Tens Unit

716
Q

What are the typical associated findings with Sudeck’s atrophy?

A
  • Dramatic changes in skin color and temperature in the affected area
  • Intense burning
  • Skin sensitivity
  • Swelling
  • Sweating (Excessive sweating; Hyperhidrosis)
  • Hypertrichosis (excessive hair growth)
717
Q

What condition is “a chronic pain condition, with continuous intense pain out of proportion to the severity of the injury, which gets worse rather than better over time”?

A

Complex Regional Pain Syndrome

718
Q

What does an increase in Red Blood cell indicate?

A

1: Polycythemia Vera
2: High altitude

719
Q

A decrease in what three hematology categories will indicate Anemia?

A

Red blood cells
Hemoglobin
Hematocrit

720
Q

What two things does an increase in Hemoglobin and Hematocrit indicate?

A

Dehydration: loss of blood fluid volume

Polycythemia Vera

721
Q

What type of Anemia is present if there is an increase in:
Mean Corpuscular Volume (MCV)
Mean Corpuscular Hemoglobin (MCH)
Mean Corpuscular Hemoglobin Concentration (MCHC)

A

Macrocytic Anemia (>100)

722
Q

What would cause a patient to have Microcytic Anemia?

A

A decrease in anyone of the following: (

723
Q

What three conditions will have an increase in Platelets Thrombocytes?

A

Polycythemia
Trauma
Blood loss

724
Q

What three conditions can a decrease in Platelets Thrombocytes be seen in?

A

Anemia Extensive
Burns
Thrombocytopenia

725
Q

What is the of number Leukocytes that must be seen in a person to be diagnosed as Leukemia?

A

Over 50,000

726
Q

What three conditions will have an increase in White Blood Cells (WBC)?

A

Acute Infection
Inflammation
Leukemia

727
Q

What two conditions will see a decrease in White Blood Cells (WBC)?

A

Overwhelming infections

Viral conditions

728
Q

What are the five different categories of White Blood Cells (WBC) and there associated percentages?

A 
Neutrophils-60%
Lymphocytes-30%
Monocytes-8%
Eosinophils-3%
Basophils-0%
Never
Let 
My
Engine
Blow

60,30,8,3,0

729
Q

What does an increase in Neutrophils indicate?

A

Bacterial Infection

730
Q

In increase in what White Blood Cell (WBC) category would indicate a viral infection?

A

Lymphocytes

731
Q

What does and increase in Monocytes indicate?

A

Chronic inflammation

732
Q

An increase in Eosinophils means what?

A

Allergies

Parasites

733
Q

What is the radiographic finding of a Sickle Cell Anemia patient?

A

H-shaped vertebrae

734
Q

What population makes up about 10% of those with Sickle Cell?

A

African American

735
Q

What is another name for Thalassemia?

A

Mediterranean Anemia

736
Q

What two conditions are present with Thalassemia?

A

Microcytic anemia

Target cells

737
Q

What is the cause of Erythroblastosis Fetalis?

A

Rh+ Father and Baby

Rh- Mother

738
Q

What is the most common Megaloblastic Anemia?

A

Macrocytic Normochromic

739
Q

In what type of Megaloblastic Anemia will be seen in chronic alcoholics, pregnancy and malabsorption?

A

B9/Folic Acid

740
Q

What type of Anemia is seen in “Lack of intrinsic factor due to chronic atrophic gastric mucosa causing loss of parietal cell”?

A

B12/Cyanocobalamin
Pernicious Anemia

(Unconjugated, Indirect bilirubin= Pre-Hepatic (All have Prefixes)–> Decrease in B Vitamins

741
Q

What test is done for the diagnosis of Pernicious anemia?

A

Schilling test (24 hour urine)

742
Q

What is the treatment for Pernicious Anemia?

A

B12 Shots

743
Q

What can prolonged Pernicious Anemia lead to and what is it’s AKA?

A

Posterolateral Sclerosis (PLS)

AKA- Combined systems disease

744
Q

Iron Deficiency anemia is what kind of anemia?

A

Hypochromic Microcytic (Too Tiny)

745
Q

Who often is seen with having Hypochromic Microcytic anemia?

A

Chronic blood loss

Pregnancy

746
Q

In Iron Deficiency Anemia where is blood often found?

A

Occult blood in the stool

747
Q

What type of anemia is Aplastic Anemia?

A

Normochromic Normocytic

748
Q

What nine populations are seen to have Normochromic Normocytic Anemia?

A

Drug users
Chemotherapy
Radiation
Multiple Myeloma
Rheumatoid Arthritis
Leukopenia
Acute Blood Loss
Benzene poisoning
Thrombocytopenia

749
Q

What two things does red urine indicate?

A

Blood (Infections or Cancer)

Food pigments

750
Q

What are three things green urine indicate?

A

Biliary duct obstruction
Pseudomonas Infection
Bad protein digestion

751
Q

What are three problems if a patients urine is Blue?

A

Diuretic Therapy
Pseudomonas infection
Bad protein digestion

752
Q

What are the indications associated with Brown urine?

A 
Bile Pigments
Blood
  Biliary duct obstruction
  Occult blood
  Homogentisic acid
753
Q

What does black urine indicate?

A 
Homogentisic Acid
Urobilin
  Ochronosis  (Accumulation of Homogentisic Acid)
  Hemolysis
  Bacteria
754
Q

What six things can cause the appearance of urine to be hazy/cloudy?

A 
Epithelial Cells
White Blood Cells (WBC)
Red Blood Cells (RBC) 
Crystals
Sperm 
Microorganisms
755
Q

What two things will give urine a Milky appearance?

A

Fat

White Blood Cells (WBC)

756
Q

What three things can cause an increase in Specific Gravity of urine?

A

Bacterial infections
Diabetes Mellitus
Kidney Abnormalities

757
Q

What five conditions will be seen if there is an increase in glucose in the urine?

A 
Diabetes Mellitus 
Shock
Head injury
Pancreatic disease
Renal tubular disease
758
Q 
An increase in \_\_\_\_\_\_\_\_ in the urine will indicate the following:
Starvation
Diabetes Mellitus
Weight loss diets
Inadequate Carbohydrate intake
A

Ketones

759
Q

What four conditions are seen with and increase in protein in the urine?

A

Kidney disorder
Toxemia of Pregnancy
Diabetes Mellitus
Multiple Myeloma

760
Q

What does and increase in Urobilinogen indicate? (Two things)

A

Hemolytic Disease

Hepatic Disease

761
Q

What does and increase in Urobilinogen indicate?

A

Biliary Obstruction

762
Q

What two conditions are indicated with an increase in Bilirubin in the urine?

A

Hepatic Disease

Biliary Obstruction

763
Q

An increase of blood in the urine can indicate ____________? (6 Things)

A 
Tumor
Trauma
Kidney Infection
Kidney Stone
Hypertension
Bleeding Disorder
764
Q

What is the clinical term for Red Blood Cell Cast?

A

Glomerulonephritis

Know what all Cast means for Boards

765
Q

What is the clinically term for White Blood Cell Cast?

A

Pyelonephritis

766
Q

What does a waxy cast indicate? (Two things)

A

Renal failure

Nephritis

767
Q

What does and Increase on the Acid Phosphatase (PAP) indicate?

A

Prostatic Carcinoma

768
Q

What does a reversed Albumin/Globulin (A/G) Ratio indicate?

A

Multiple Myeloma

769
Q

What three things does an increase in Alkaline Phosphatase indicate?

A

Osteoblastic lesions
Hepatic Disease
Hyperparathyroidism

770
Q

What does an increase in the Amylase test indicate?

A

Acute Pancreatitis

771
Q

What does the ANA (FANA) test indicate?

A

Collagen diseases
i.e. Systemic Lupus Erythematous
Scleroderma

772
Q

What is the spelt out name of ASO-Titer?

A

Antistreptolysin-O

773
Q

What two conditions have an increase in ASO-Titer?

A

Rheumatic Fever

Acute Glomerulonephritis

774
Q

What does an increase in direct bilirubin indicate? (Two things)

A

Hepatitis

Duct obstruction

775
Q

What does an increase in indirect bilirubin indicate?

A

Hemolytic Disease

776
Q

What does an increase in Blood Urea Nitrogen (BUN) indicate? (Four things)

A

Renal disease
Dehydration
Hypotension
Urinary tract infection

777
Q

What two indications does a decrease in Blood Urea Nitrogen (BUN) have?

A

Hepatic disease

Pregnancy

778
Q

What four conditions have an increase in Calcium?

A

Muscle weakness
Hyperparathyroidism
Hypervitaminosis D
Metastatic Disease

779
Q

What four conditions does an decrease in Calcium indicate?

A

Muscle tetany
Chvostck’s Sign; Hypocalcaemia (tap facial nerve, mastication muscle contracts)
Renal Failure
Malnutrition

780
Q

What does CK BB indicate?

A

Brain tissue

781
Q

What does CK MB indicate?

A

Myocardial Tissue

782
Q

What does CK MM indicate?

A

Skeletal Muscle

783
Q

What does and increase in Creatine Phosphokinase (CPK) indicate?

A

Muscle Necrosis

784
Q

What is the best test for the kidney?

A

Creatinine

785
Q

What two conditions are indicated by in increase in Creatinine?

A

Kidney disease

Hypovolemic Shock

786
Q

What does a decrease in Creatinine indicate?

A

Muscular Dystrophies

787
Q

An increase in C-Reactive Protein indicates what three conditions?

A

Tissue necrosis
Infections
Rheumatoid Arthritis

(This test is more Sensitive than Erythrocyte Sedimentation Rate (ESR))

788
Q

What is the name of the Screening test for AIDS?

A

ELISA

789
Q

What two conditions are indicated by a decrease in Erythrocyte Sedimentation Rate (ESR)?

A

Sickle Cell Anemia

Polycythemia

790
Q

In increase in Erythrocyte Sedimentation Rate (ESR) is indicative of what five conditions?

A 
Infection
Rheumatoid Arthritis
Tuberculosis
Temporal Arteritis
Multiple Myeloma
791
Q

What test is positive in Syphilis?

A

Florescent Treponema Antibody (FTA)

792
Q

An increase in blood Glucose indicates what three possible conditions?

A

Diabetes Mellitus
Cushing’s
Renal/Liver Disease

793
Q

What does a decrease in blood glucose indicate? (3 conditions)

A

Insulin overdose
Addison’s
Starvation

794
Q

What Is the best test for Chronic Alcoholism?

A

Gamma-Glutamyl Transferase (GGT)

795
Q

What is the name of the test used for Diabetics?

A

Glucose Tolerance test (GTT)

796
Q

What is the best test to monitor the progression of Diabetes Mellitus over a 2-3 month period?

A

Glycosylated Hemoglobin

797
Q

What is the Hetrophile (Paul Bunnel) test used to indicate? (2 things)

A

Mononucleosis

Viral Meningitis

798
Q

In what five conditions will there be an increase in Human Chorionic Gonadotropin (HCG)?

A

Hydatiform mole
Choriocarcinoma
Seminoma
Testicular Teramtoma
Multiple pregnancies

799
Q

What are two indications where you would see a decrease in Human Chorionic Gonadotropin (HCG)?

A

Ectopic pregnancy

Threatened abortion

800
Q

What four conditions will you see Human Leukocyte Antigen Locus (HLA) B27?

A

Psoriatic Arthritis
Enteropathic Arthritis
Ankylosing Spondylitis
Reiter’s (Reactive Arthritis)

PEAR

801
Q

An increase in HDL cholesterol indicates what?

A

Low risk of coronary heart disease

802
Q

What test would indicate a high risk of coronary heart disease?

A

Decreased levels of HDL cholesterol

803
Q

What does and M-spike on Immunoelctrophoresis indicate?

A

Multiple Myeloma

Immunoelctrophoresis is the BEST test for Multiple Myeloma

804
Q

What two conditions are indicated by a decrease in Cerebrospinal Fluid (CSF) glucose?

A

Bacterial Meningitis

Acute Pyogenic infections

805
Q

What two indications does and increase in I-131 uptake have?

A

Hyperthyroidism

Endemic Goiter

806
Q

What does a decrease in I-131 uptake indicate? (Two conditions)

A

Hypothyroidism

Thyroid Cancer

807
Q

In what two conditions would you test for ketones?

A

Carb Restriction
Diabetic Acidosis
Starvation

808
Q

What test is specific for AIDS?

A

Western Blot

809
Q

What is the name of the serologic screening test for syphilis?

A

Venereal Disease Research Laboratory (VDRL)

810
Q

What does an increase in uric acid indicate? (Two conditions)

A

Gout (Podagra; inflammation of the big toe)

Renal Failure

811
Q

What test indicates Syphilis?

A

Treponema Pallidum Immobilizing Agent (TPI)

812
Q

What three conditions are indicated by an increase in Lactic Dehydrogenase (LDH)?

A

Myocardial Infarction (MI)
Congestive Heart Failure (CHF)
Muscular Dystrophy

813
Q

When would you expect to see a decrease in Lactic Dehydrogenase?

A

Cancer Therapy

814
Q

What does an increase in Lipase indicate?

A

Acute Pancreatitis

815
Q

An increase in Cholesterol lipids indicates what two things?

A

Early starvation

Diabetes Mellitus

816
Q

What two conditions are seen with a decrease of Cholesterol lipids?

A

Late starvation

Liver disease

817
Q

A decrease in Triglyceride lipids indicates what two conditions?

A

Cirrhosis

Malabsorption

818
Q

What three conditions are seen when there is an increase in Triglyceride lipids?

A

Hyperlipidemia
Diabetes Mellitus
Atherosclerosis

819
Q

In what condition would you expect to see LE Cell

A

Active Systemic Lupus Erythematous

820
Q

In what three conditions would you see and increase in Phosphorous?

A

Acromegaly
Kidney disease
Hypervitaminosis D

821
Q

What are three conditions that you would see a decrease in Phosphorous?

A

Rickets
Hypovitaminosis D
Hyperparathyroidism

822
Q

What two conditions will you see an increase in Proteins?

A

Multiple Myeloma

Diabetic Acidosis

823
Q

In what two conditions will you see a decrease Proteins?

A

Liver disease

Kidney syndrome

824
Q

What will be increased if a patient has Viral Meningitis?

A

Proteins of the Cerebrospinal Fluid (CSF)

825
Q

In what two conditions will there be an increase in Prothombin time?

A

Clotting Time
Vitamin K deficiency
Hepatocellular disease

826
Q

In what three conditions will you see an increase in Serum Glutamic Oxaloacetic Transaminase (SGOT/AST)?

A

Myocardial Infarction
Liver conditions
Muscular Dystrophy

827
Q

When would you expect to see a positive RA Latex? (7 Conditions)

A 
Seropositive Arthritis 
Systemic Lupus Erythematous (SLE)
Tuberculosis (TB)
Cancer
Sjogren's
Still's Disease  
Scleroderma
828
Q

In what two conditions would you see in increase in Serum Glutamic Pyruvic Transaminase (SGPT/ALT)?

A 
Hepatitis 
Myocardial Infarction (MI)
829
Q

In what two condition would you see an increase in Triiodothyronine (T3) and Thyroxine (T4)?

A

Hyperthyroidism

Pregnancy

830
Q

In what two condition would you see an decrease in Triiodothyronine (T3) and Thyroxine (T4)?

A

Cirrhosis

Hypothyroidism

831
Q

What condition are you looking for if you order an Arterial Blood Gas test?

A

Advance Chronic Obstructive Pulmonary Disease (COPD)

832
Q

What two conditions are confirmed by an Aspiration test?

A

Gout

Bacterial Arthritis

833
Q

What condition does a Balloon Angioplasty test for?

A

Obstructive Atherosclerosis

834
Q

What does a biopsy test for?

A

Cancer, Tumor; i.e Hodgkin’s

835
Q

What two conditions can a Bone Scan be helpful for?

A

Intrinsic Bone changes

Hidden fracture

836
Q

What condition would you order a Bronchoscopy?

A

Bronchogenic Carcinoma (Lung Cancer)

837
Q

For what condition would a Colonoscopy be ordered?

A

Lower Gastrointestinal (GI) Disease

838
Q

What conditions would you order a Computed Tomography (CT)? (Five Topics)

A 
Trauma
Infection 
Vascular 
Neoplastic
Arthritic/Metabolic Disorders

Lung, Appendix, Canal Stenosis

839
Q

For what condition is a DEXA scan ordered?

A

Osteoporosis

840
Q

When is a Doppler ultrasound ordered?

A

Arterial Alterations

841
Q

What three conditions would you order a Electroencephalography (EEG)?

A

Epilepsy
Sleep disturbance
Encephalopathies

842
Q

When would you order a Electromyography (EMG)?

A

Muscle Atrophy

Lower Motor Neuron Lesion (LMNL)

843
Q

What is an Endoscopy test for?

A

Gastrointestinal (GI) tract

844
Q

What test is used for indicating an abdominal tumor?

A

Laparoscopy

845
Q

What condition is the Mantoux test ordered to confirm?

A

Tuberculosis (TB)

Additional test to be ordered:
TINE
PPD

846
Q

What conditions would be appropriate to order a Magnetic Resonance Image (MRI)? (Six Topics)

A 
Soft Tissues 
Spinal tumor
Disc
Rotator Cuff
Meniscus 
Avascular Necrosis
847
Q

What is the appropriate test for Peripheral nerves?

A

Nerve Conduction Velocity (NCV)

Lower Motor Neuron Lesion (LMNL)

848
Q

What two test “should be” order together?

A

Nerve Conduction Velocity (NCV)-Peripheral nerves
Electromyography (EMG)- Muscle Atrophy

Lower Motor Neuron Lesion (LMNL)

849
Q

What conditions should a Positron Emission Tomography (PET) be ordered? (Four Topics)

A

Bone and Soft tissue
Tumor
Heart
Brain

850
Q

What is the Spirometer used for?

A

Chronic Obstructive Pulmonary Disease (COPD)

851
Q

What two conditions are indicated using a Sputum culture?

A

Strep throat

Tuberculosis (TB)

852
Q

What two conditions are confirmed by the use of the Stress Test?

A

Atherosclerosis

Angina

853
Q

How is Glaucoma tested?

A

Tonometer

854
Q

Ultrasound is used to test what three conditions?

A

Aneurysm
Organs
Pregnancy

855
Q

What is the Stalk Test used to diagnosis?

A

Spondylolisthesis

856
Q

For what five conditions would you order a Single Photon Emission Computed Tomography (SPECT)?

A 
Musculoskeletal System
Heart
Brain
Abdomen
Spondylolisthesis
857
Q

What is the most important part of a patient history, for Boards?

A

Age

858
Q

What is the least important part of a patient’s history for Boards?

A

Gender

859
Q

When a patient has a fever what two things will increase?

A

Heart Rate; 10 beats per minute for every degree increased

Respiratory Rate

860
Q

What are three causes of Horner’s Syndrome?

A

Thoracic Outlet Syndrome (TOS)
Whiplash
Apical Lung Tumor (Pancoast)

861
Q

All cranial nerve lesions are considered what?

A

Ipsilateral Lesions

862
Q

When two cranial nerves are affected in a condition which one is sensory?

A

The lower numbered of two cranial nerves will be considered sensory AKA Afferent

863
Q

When two cranial nerves are affected in a condition which one is motor?

A

The higher numbered of two cranial nerves will be considered motor AKA Efferent

864
Q

If there is a Cranial Nerve II problem when doing Direct/Indirect light reflex which pupils are affected?

A

Both, Cranial Nerve II (2 Pupils are effected, even numbers go together)

865
Q

If there is a Cranial Nerve III problem when doing Direct/Indirect light reflex which pupils are affected?

A

One, Cranial Nerve III (1 Pupil is effected, odd numbers go together)

866
Q

In Secondary Hyperparathyroidism (2 HPT), there is a decrease stimulation for the Pituitary Gland and also a decrease in Thyroid-stimulating hormone (TSH), what are three finding associated with this condition?

A

Breast Atrophy
Amenorrhea
Macroglossia

867
Q

What are three causes of Chronic Obstructive Pulmonary Disease (COPD)?

A

Chronic Bronchitis
Asthma
Emphysema

868
Q

What condition has an x-ray finding of Bilateral Hylarlymphadnopathy AKA Angel Wings?

A

Sarcoidosis

869
Q

What condition to Tietze Syndrome which only affects one articulation and radiates pain?

A

Costochondritis

870
Q

How can you tell Hodgkin’s from Paget’s and Blastic Metastases?

A

Hodgkin’s: Anterior Vertebral Scalloping

Paget’s: Ivory White Vertebra is much BIGGER than the others

871
Q

If Tetralogy of Fallot is left untreated what will happen?

A

Clubbing of the fingernails

872
Q

What condition is associated with Coarctation of the Aorta?

A

Marfan’s Syndrome

873
Q

Where do all signs and symptoms of Left Sided Heart Failure show up?

A

In the Lungs

874
Q

Who do you refer a patient to that has Heart Failure?

A

Cardiologist

875
Q

What condition has pain in the chest for longer than 10-15 minuets?

A

Myocardial Infarction (MI)

876
Q

How is an Aneurysm diagnosed?

A

When the aorta is wider than the vertebral bodies

877
Q

After a Myocardial Infraction, when does the enzyme CK-MB appear?

A

3-6 hours

878
Q

After a Myocardial Infraction, when does the enzyme CK-MB peak?

A

24-36 hours

879
Q

After a Myocardial Infraction, when does the enzyme CK-MB return to normal?

A

By day 3

880
Q

After a Myocardial Infraction, when does the enzyme SGOT/AST appear?

A

6-8 hours

881
Q

After a Myocardial Infraction, when does the enzyme SGOT/AST peak?

A

24 hours

882
Q

After a Myocardial Infraction, when does the enzyme SGOT/AST return to normal?

A

By day 4-6

883
Q

After a Myocardial Infraction, when does the enzyme LDH appear?

A

10-12 hours

884
Q

After a Myocardial Infraction, when does the enzyme LDH peak?

A

48-72 hours

885
Q

After a Myocardial Infraction, when does the enzyme LDH return to normal?

A

After 14 days

886
Q

What are two things to understand about Myocardial Infarction enzymes for Board questions?

A

Order of:
Elevation
How long
Return to Normal

First (CK-MB) to Last (LDH), follow the same order

887
Q

What is the most common cause of Cholecystitis?

A

Cholelithiasis (Gall Stones)

888
Q

What is Zenker’s diverticulum?

A

Out pouching of the Esophagus

889
Q

The Shilling test does not absorb Vitamin B12 leading to what condition?

A

Pernicious Anemia

890
Q

What condition has a rapid, steady decrease of renal function with or without no urine production?

A

Acute Renal Failure

891
Q

What are three things you will see in an older male patients urinary functions?

A

Patient will have:
Frequency
Urgency
Hesitancy

892
Q

An increase in the D-Dimer test indicates what condition?

A

Deep Vein Thrombosis (DVT)

893
Q

What headache is relieved by Alcohol?

A

Muscular Tension headache

894
Q

What condition will the patient present with neck and shoulder stiffness?

A

Polymyalgia Rheumatica (Temporal Arteritis, Giant Cell)

895
Q

Who do you refer a patient to that has Polymyalgia Rheumatica?

A

Ophthalmologist

896
Q

What age do you often seen a patient with a Tempromandibular Joint (TMJ) Headache?

A

Teens

897
Q

What signs and symptoms will you seen in a Tempromandibular Joint (TMJ) Headache?

A

Pain in the jaw, Tempromandibular Joint (TMJ) area
Pain with chewing
Clicking of the jaw

898
Q

What will you see in the past history of a patient with Tempromandibular Joint (TMJ) Headache?

A

Recently visited the dentist

899
Q

Who do you refer a patient with Tempromandibular Joint (TMJ) Headache to?

A

Back to the Dentist

900
Q

What term is associated with Uterine Fibroids?

A

Leiomyoma

901
Q

What is both a treatment and a diagnosis of Endometriosis?

A

Laparoscopy

Boards Part II and III (Irene Gold) (12 decks)

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