Definitions 76-100

Front 1

Soft first heart sound

Back 1

Causes: Mitral incompetence, mitral regurgitation

Front 2

Rheumatic nodules

Back 2

A local swelling or tissue lump, usually rather firm to touch

Causes: Rheumatic arthritis

Front 3

Pulses Bigeminus

Back 3

A cardiovascular phenomenon characterized by groups of two heartbeats close together followed by a longer pause. The second pulse is weaker than the first.

Causes: AV block

Front 4

Erythema marginatum

Back 4

Red rings with a raised margin and flat center that are not painful or itchy, usually found on the trunk and proximal extremities. May come and go for several months

Causes: Rheumatic fever

Front 5

Janeway Patches

Back 5

Small, non-tender palmar/planter macules

Causes: Infective endocarditis

Front 6

Papilloedema

Back 6

Swelling of the optic disk tcaused by raised intracranial pressure

Causes: tumour, intracerebral hemorrhage

Front 7

Diastolic rumble

Back 7

Low-pitched, rumbling, mid diastolic murmur. Best heardd with the patient on their left side, using the bell over the apex. Accentuated by exercise

Causes: mitral stenosis, triuspid stenosis (rarely)

Front 8

Pulsus Bisferiens

Back 8

AKA biphasic pulse

A pulse with two strong systolic peaks separated by a mid systolic dip when palpated. The valsalva maneuver can precipitate

Causes: aortic valve regurgitation, aortic regurgitation with stenosis, HOCM

Front 9

Anosmia

Back 9

Loss of sense of smell, sometimes accompanied by altered ability to tase

Causes: sinusitis, nasal congestion, damage to olfactory filaments after head injury, local nerve compression or invasion by skull base tumours, Parkinson's, Huntington's

Front 10

Pill Roll Movement

Back 10

A rest tremor in which the fingers and wrist move in a manner reminiscent of a rhythmic voluntary manipulation of small objects in the hand, e.g. pills.

Causes: Chlorpromazine teratogenicity, Creutzfield-Jakob disease, dysphasic demensia, HIV/AIDs, Haloperidol teratogenicity, Multiple system atrophy, Paraneoplastic syndrome, Multiple system atrophy, Parkinson's

Front 11

Waterhammer pulse

Back 11

Colapsing pulse, when peak is felt early followed by rapid descend. Exaggerated by lifting the patients arm above their heart

Causes: Physiological (fever, pregnancy), aortic regurgitation, patent ductus arteriosis, systolic hypertension, bradycardia, aotiopulmonary window, rupture of sinus of valsala into heart chambers, cor pulmonale, anemia, cirrhosis, beriberi (thiamine - Vit B1 deficiency), thyrotoxicosis, Atreriovenous fistula, Pagets disease, Chronic alcoholism

Front 12

Widely split S2

Back 12

Delay between aortic and pulmonary valves closing

Causes: physiological (inspiration), right bundle branch block (variable with respiration), ASD (fixed),

Front 13

Erythema nodosum

Back 13

Painful dusky blue-red nodules commonly seen in lower legs due to vasculitis is deep dermis and subcutaneous fat

Causes: Infections (TB, streps, brucellosis, leprosy, mycoplasma, rickettsia, chlamydia), Drugs (COC's, sulphonomides), sarcoidosis, ulcerative colitis, Crohn's

Front 14

Aura

Back 14

The perceptual disturbance experienced by some migraine or epilepsy sufferers before an attack

Front 15

Petechia

Back 15

Flat pinhead-sized macules of extravascularised blood in the dermis. Larger are caled purpura and may be palpable. When involving deeper structures it is called ecchymosis. Petechia of the face and eyes are seen in asphyxia

Causes: Infections (Cerebral malaria, congenital syphilis, Crimean-Congo hemorrhagic fever, Dengue fever, Ebola, Endocarditis, H1N1, Hanta virus, Marburg virus, Rocky mountain spotted fever, scarlet fever, typhus), hypocalcemia idiopathic thombocytopenic purpura, leukemia, aplastic anemia, Kwasiorkor, Marasmus, Henoch-Schonlein purpura

Front 16

Mask like face

Back 16

Expressionless face with little or no sense of animation. Also called mask like facies

Causes: Parkinson's, depression, facioscapulohumeral type muscular dystrophy, Prader-Willi disease, infantile botulism, Wilsons disease and myotonicdystrophy

Front 17

Athetosis

Back 17

Writing motions that are slower and more sustained than chorea

Causes: Wilson's, Huntington's, Porphoria, cerebral birth injury, cerebral trauma, drugs (levodopa, dopamine agonists, phenothiazides, tricyclic antidepressants, COC's), Pregnancy, thyroxicosis, hypoparathyroidism, hypoglycemia

Front 18

Hypocalcemia

Back 18

Calcium levels below 3.5mmol/L or 9mg/dL

Symptoms: Tetany in hands feet or throat, carpopedal spasm, depression, numbness of and and feet and around the mouth, fits, perioral tingling and paresthesia, Chvoseks signs, hyperactive reflexes, laryngospasm, cardiac arrhythmias, ECG changes, prolonged QT or ST intervals

Causes: Chronic renal failure, pancreatitis, parathyroid disease

Front 19

Leukoplakia

Back 19

Premalignant, white lesions of the mucous membrane of the oral cavity that are adherent (cannot be scraped off).

Diagnosis of exclusion - candidiasis or lichen planus

Front 20

Kerley-B lines

Back 20

Kerley Lines: Thin linear pulmonary opacities caused by fluid or cellular infiltration into the interstitium of the lungs. Sign seen on chest X-rays with interstitial pulmonary oedema

Kerley B lines: short parallel lines at lung periphery. Represent interlobular septa, usually less than 1cm, parallel to each other and at right angles to the pleura. Located peripherally in contact with the pleura but absent along fissural surfaces. Most frequently seen at the lung bases at the costophrenic angle on a PA radiograph and substernal on a lateral radiograph

Causes: Congestive heart failure, interstitial lung diseases

Front 21

Positive PPD/Tine test

Back 21

AKA Mantoux screening test, Tuberculin Sensitivity test, Pirquet test, PPD test for Purified Protein Derivative

Diagnostic tool for TB. Positive = TB exposure

>5mm positive in - HIV, recent TB contact, persons with nodular or fibrous changes on X-Ray in keeping with old healed TB, patients with organ transplants or who are otherwise immunosupressed

>10mm positive in - recent arrivals (<5 years) from high risk countries, injection drug users, residents and employees in high risk settings, mycobacteriology lab personal, children <4, persons with chronic disease that put them at high risk

>15mm positive - people with no known risk factors for TB

Front 22

Froin Syndrome

Back 22

A sign of blockage of CSF flow. Lumbar puncture shows CSF with high protein level, xanthochromia but normal cell count

Causes: Spinal TB, advanced spinal tumour, spinal meningitis

Front 23

Ecchymosis

Back 23

A macular red or purple hemorrhage, >2mm in diameter, in skin or mucous membrane

Causes: injury or trauma, aging skin, leukemia, anticoagulants (warfarin, heparin, aspirin), steroids, septicemia

Front 24

Barrel chest

Back 24

Increased AP diameter, tracheal descent and decreased chest expansion

Causes: chronic hyperinflation e.g. COPD, kyphosis

Front 25

Arcus Corneals

Back 25

White or grey crescent shaped opacity at periphery of cornea. It results from cholesterol deposits in or hyaline degeneration of the corneal stroma

Causes: may be associated with ocular defects or with familial hyperlipidemia