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54 Cards in this Set
- Front
- Back
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What do you look for in the general assessment?
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Nutritional Status
Conciousness Distress Skin Color Hygiene Posture Hydration |
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Name some diagnostic features of the hand.
Name some diagnostic features of clubbing. (10) |
Clubbing:
Chronic Diseases such as liver, heart, and lung. |
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What is the cause of capillary refill being longer than 3 seconds?
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Hypoperfusion
PAD (peripheral arterial disease) Shock |
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What is somebody has anatomical snuff box tenderness, what would be the cause?
What are 3 complications? Treatment? |
Scaphoid Fracture
Sprains aren't common, so fracture of scaphoid is hard to see on X-ray, so usually order MRI. 1) Avascular Necrosis 2) Non-union 3) Arthritis Splint for a week or two. |
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What about localized Tenosynovitis of the thumb?
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De Quervan's Tenosynovitis.
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Describe Swan Neck Deformity.
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PIP hyperextension
DIP flexion |
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What is a Radial Head Fracture Called?
Cause? |
Colle's Fracture aka Dinner's Fork Deformity
Outstretched arm. |
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Fungal infection of nail that gives you hard, yellow, brown icky nail.
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Onychomycosis
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5 Signs/Lab findings for iron deficient anemia.
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1) Microcytosis
2) Increased TIBC 3) Decreased ferritin 4) Decreased serum iron 5) Glossitis (inflammed tongue) |
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Pitted Nails, what are the association?
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1) Psoriasis
2) Reiter's Syndrome 3) Sarcoidosis |
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Nails that have depression in nail bed due to temporary cessation of nail growth.
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Beau's Lines
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More pallor of nails w/ distal pink band.
Causes: |
Terry's Nails
1) Cirrhosis 2) Chronic CHF 3) Adult-Onset Diabetes Mellitus 4) Hemodialysis Patients 5) Renal Transplant Recipients 6) HIV patients |
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Transverse white bands (leukonychia) parallel to the lunular aka Rainbow nails.
Causes: |
Muehrcke's Nails
Benign, caused by abnormalities in nail bed vascularization. |
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11 Specific Causes of Clubbing.
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Diseases of the lung:
1) Bronchiectasis (ie, CF) 2) Abcess or empyema 3) Bronchiogenic Carcinoma 4) Pneumoconiosis 5) Pulmonary Sepsis 6) Chronic Infections 7) Fibrosing Alveolitis Diseases of the Heart: 8) Bacterial Endocarditis 9) Cyanotic congenital heart disease 10) IBD (like Chron's) 11) Cirrhosis of the Liver |
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Pt. has crepitation felt in the first dorsal compartment of the radial-styloid from repetitively ringing a bell?
What is the diagnostic test? |
De Quervan's Tenosynovitis.
The Finkelstein Test |
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Diagnosis w/ hypothenar and ring finger contracted w/ all other fingers fine.
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Claw Hand stemming from Ulnar Nerve Damage
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What sign is not reversed In CTS (Carpal Tunnel Syndrome)?
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Median Nerve Damage
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How would you diagnose CTS (Carpel Tunnel Syndrome)?
Name some other options |
Nerve Conduction Studies/Electromyography: Decreased speed of conduction
1) Phalen's test: Flexion at wrist causes pain within 1 minute 2) Tinnel's Test: Tapping over flexor retinaculum elicits pain/tingling sensations in line w/ distribution of median nerve. 3) Durkan Test: Applying firm pressure over flexor retinaculum for 30 sec. elicits symptoms. |
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A 38 year old male complains of progressive inability to open his door knob for the past six months. He smoked and drank alcohol heavily for five years, but quit three years ago. On examination, he looks well nourished. His Vital signs are normal. He was unable to perform rapid, alternating movements.(e.g. Pronation and supination) when prompted to do so. In addition, his movements appears slow and a little awkward. Other physical examinations are normal. What is your most likely diagnosis?
a)Parkinsonism b)Friedreich’s ataxia c)Dysdiadochokinesia d)Multiple Sclerosis e)Ataxia telangiectasia |
Dysdochokinesia
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What is the memory devices that goes w/ polydacyly?
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•V – Vertebral anomalies-hypoplastic vertebrae or hemivertebra
•A – Anal atresia or Imperforate anus •C – Cardiovascular anomalies- ASD, VSD, TOF •T - Tracheo-esophageal fistula - •E – Esophageal atresia •R – Renal (Kidney) or radial anomalies-single umbilical artery (there are usually two arteries and one vein). •L – Limb defects -extra digits (polydactyl), fusion of digits (syndactyly) or limb hypoplasia. |
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Nasty nodules on ear lobe and hand.
Histologically. |
Gout/Podagra (Hyperuricemia)
MSU (monosodium urate) crystals. Yellow on parallel light. Would be blue on perpendicular light. |
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What's a condition that is associated w/ pseudogout?
Name the other 3 associations and memory device. |
Hemochromatosis
4 H's: Hyperthyroidism Hemochromatosis Hypermagnesemia Hypophoshatemia |
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What's the main physical difference between Bullous Pemphigoid and Pemphnigoid Vulgaris?
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Bullous Pemphigoid: Blisters don't easily rupture.
Pempigus Vulgaris: Blisters do easily rupture. Bullae is formed by formation of IgG autoantibodies targeting type XViI collagen component of hemidesmosomes. |
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PE of Bullous Pemhigoid and Pemphigus Vulgaris.
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Positive Nikolsky's: Pemphigoid
Negative: for Bullous Pemphigoid |
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Somebody w/ Photoallery, what medication are they taking?
Associated autoantibodies? |
HCTZ
anti-Ro (SS-A) antibodies (b/c patients w/ drug-induced reactions commonly have this. |
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Borrelia Burgdoferi "Lymes Disease":
Can't survive w/o? It's a cluster of enzymes w/ what molecule? |
Can't survive w/o iron.
iron-sulfur cluster of enzymes w/ manganese. |
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Presents like Acanthosis Nigricans but in sweaty areas, and can be reddish.
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Hidradenitis Suppurativa (HS)
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NF1 association?
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Von-Recklinghausen aka NF1
ADHD |
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For HEENT, Palpation, name the memory device for Lymphatics.
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COPASSS
Cervical Occipittal Parotid Auricular Submental Supraclavicular Submandibular |
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For HEENT, the trans-illumination test is for what condition?
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Maxillary Sinusitis
Only test where Positive sign is normal and Negative sign is the abnormal condition |
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Picture of scary lady.
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Cachetic w/ brown spot just above the clavicle, and tracheal deviation.
Problem: Mass in Lung. Don't say what type of tumor, just say mass. |
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Picture of jokerkid
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Cancrum oris
•Also known as Noma or gangrenous stomatitis •Gangrenous disease with tissue destruction of mouth and cheek. |
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How much alcohol is safe in pregnancy?
How would a patient present w/ FAS? |
No alcohol is safe in pregnancy.
FAS features: Smooth Philtrum |
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Reason for getting flushed face but not around the eye.
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Amphetamines
Niacin Jarisch-Herxheimer Reaction CO exposure: Haldane effect |
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Cause of a cleft palate.
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Fusion failure of maxillary processes and medial nasal swelling.
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Slapped cheek and red eyes
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Kawasaki Disease
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Unilateral Exopthalmus causes.
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Neuroblastoma.
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Mermaid Leg.
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Potter's Sequence.
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Name the Potter's Sequence.
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Failure of mesonephric duct to produce ureteric bud (5th week)
which leads to Bilateral Renal Agenesis (BRA) which leads to: Decreased amniotic fluid production which leads to Oligohydramnios which leads to Fetus compressed by mothers uterus hypoplasia of the lungs (hydrodynamic pressure, proline) which leads to Potter's facies, sirenomelia, and clubbed feet. |
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Name some special features w/ Downs Syndrome.
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Simian Crease
Epicanthial folds Microgenia (small chin) Macroglossia (protrusion or oversized tongue) Prominent epicanthial folds of eyelid Upslanting palpebral fissures Wide space between 1st 2 toes Atlanto-odontoid dislocation (increased angle between 1st and 2nd cervical vertebrae due to laxity of ligaments |
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Name 5 complications of Down's.
Benefits of Down's |
ALL
ASD Hirshsprung's disease Mental Retardation Brushfield Spots Obstructive Sleep Apnea Protective against cancers, inflammatory markers, reduced atherosclerosis, and reduced risk of diabetic neuropathy. |
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How would Hirshprung's Disease present?
Pathophysiology? |
Absent Bowel Sounds
Distended in Rectum No Gas Skinny kid w/ fat belly Absecence of both myenteric and auerbach's plexus |
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How would you find out in utero, if fetus has Downs?
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Amniocentesis (15th-20th week)
Complication: Amniocentesis (raised IL-6, inflammatory marker) |
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What are the 4 signs of inflammation?
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DR CAT
Dolor Rubor CAlor Tumor |
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What is the 2-headed baby called?
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Dermoid Cyst, in the form of encephalocele
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Image of swelling below angle of the mandible.
What is the cause? |
Brachial Cleft Cyst
(Persistent Cervical Sinus) Failure of obliteration of 2nd brachial cleft |
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What condition is Lhermitte sign associated w/?
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Cervical Osteoarthritis
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MEN 1, is a defect in what gene?
MEN 2, mutation in what gene? |
Menin gene
RET (receptor tyrosine kinase) |
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How would you palpate for the thryoid?
If consistecy is hard what would it be? If soft? If tender? What are you auscultating for in the thryoid and what does it mean? |
From the front or back and have them swallow water.
hard: cancer soft: toxic goiter tender: acute infection or hemmorhage Bruit, suggesting goiter |
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What is the sign where man holds his hands up in the air and head turns red?
Cause if positive? |
Pemberton's Sign
Causes: Superior Thoracic Inlet Obstruction: Enlarged thyroid impairs SVC outflow from head and neck |
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Cause of Marcus Gunn pupil.
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Lesion of optic nerve distal to optic chiasma.
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Papilledema is a problem with?
Copper wire is a problem with? Siler wire is a problem with? AV nicking is an issue with? All are a problem w/ what condition? |
Papilledema: Edema optic disc
Copper Wire: moderate vascular wall changes. Silver wiring: severe vasular wall hypertrophy AV nicking: Arteriovenous crossing abnormality. Hypertensive Retinopathy |
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What is the organism associated w/ a stye (hordeolum)?
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S. Aureus
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Kid w/ Down's, what spots?
Pathology? |
Brushfield Spots
Kunkmann-Wolffian bodies |
