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102 Cards in this Set
- Front
- Back
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PSA Levels are???
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under 4-normal
4-10 borderline high 10-20 75% risk of cancer >20 90% risk of cancer |
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The Dentate line is important for what?
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hemroids
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Black blood in the stool usually means blood is coming from where? And is also called what?
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-high in GI tract
-melana |
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If red stool it usually means that blood is coming from where?
It is also called what? |
-colon
-hematochezia |
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What color usually indicates a positive on hemoccult test?
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Blue
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A healthy prostate should not protrude more than how many cm into the rectum?
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1 cm
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In men under 35, prostatitis is usually caused by what?
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-STD
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In med over 35, prostatitis is usually caused by what?
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E.Coli
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Prostatitis is usually accompanied by what?
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a fever
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What are some findings in rectal cancer?
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-firm nodules with rolled edge
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How does a rectal shelf feel?
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firm and nodular
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A rectal shelf usually indicates what disease?
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peritoneal metastases
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Internal hemorrhoids are at or above what?
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the dentate line
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Tell me about external hemorrhoids.
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below the dentate line and usually covered with skin
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What is an anorectal fistula?
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-an inflammatory tract or tube that ipens at one and into the anus or rectum and at the other end onto the skin surface or into another viscus
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What are common causes of perirectal irritation and itch?
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-pinworms and candida
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A pencil like stool can be indicative of what?
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cancer
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A gray or tan stool can indicate what?
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-obstructive jaundice
-conjugated billirubin cannot pass into intestine instead enters the bloodstrem |
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A black or tarry stool can indicate what?
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-duodenal ulcer hemorrhage
-gastric ulcer hemorrhage -mucosal tears of the esophagus or fundus -esophageal varices -erosive gastritis -NSAIDS |
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Bright Red Blood Per rectum can indicate what diseases?
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-hemorrhoids
-fissures -diverticulosis -colorectal cancer |
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What are the lymph nodes that are accessible to physical examination?
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-cervical nodes
-axillary nodes -inguinal/femoral nodes |
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If you find an abnormal lymph node, you should think SLAP, which stands for what?
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-spleen
-liver -associated lymph sites -primary site |
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What are some features taht you should note when assessing pulses?
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-rate
-rhythm -symmetry -character -presence of burit |
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WHat are the 6 P's?
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-parethesia
-pain -palor -pulselessness -paralysis -Poikilothermia |
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What are some causes for concern a vascular physical exam?
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-pain in the arms or legs
-intermittent claudication -cold, numbness, pallor in the legs, hair loss -color change in findertips or toes -swelling calves, legs, or feet -swelling with redness or tenderness |
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What is PAD?
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-pain in the legs that stops when you rest
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What is classic triad of symptoms for PAD?
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-exercise-induced calf pain
-pain causes patient to stop exercise -relief of pain within 10 minutes of stopping exercise |
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What are trophic changes?
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shiny, hariless skin, dystrophic nail changes and depedent rubor associated with peripheral arterial occlusive disease
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What is pallor on elevation?
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-Lift the leg and it gets red, but put it down and it goes back to normal
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What is the common name for Telaniectasias?
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SPider veins
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What is the edema grading scale?
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-1+: mild pitting, slight indentation
-2+: moderate pitting, indentation subsides rapidly -3+:deep pitting to 6mm, remains for a short time after pressure applied -4+: deep pitting >6mm, leg is very swollen |
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What is the ratio that you want for an Ankle-Brachial Index (ABI)?
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1:1
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Resting and post exercise Systolic BP in ankle and arm
0.9-1.3 <.9 0.5-0.84 <0.5 |
-normal
-95% sensitiviety for angiographic PVD -correlates w/claudication -indicates advanced ischemia |
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Deviation of the spine posteriorly?
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kyphosis
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Deviation of the spine anteriorly is what?
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Lordosis
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A marked kyphosis resulting in a hunchback deformity.
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Gibbus
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Deviation of the spine laterally
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scoliosis
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Dyspnea?
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difficulty breathing
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Frating, crackling or popping sounds and sensations?
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crepitis
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Palpable vibration.
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Fremitus
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When is fremitus decreased?
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-fluid
-COPD -PTX -Pleural Effusion |
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When is fremitus increased?
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consolidation
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Crackles and rales are what kind of sounds?
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discontinuous
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Wheezes and rhonci are what kind of sounds?
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continuous
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A high-pitched musical sounds that usually indicates narrowed airways?
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Wheezes
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Continuous rattle; fluid in the large airways, and can clear with coughing?
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Rhonci
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High pitched sound due to turbulent air flow in the upper airway?
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Stridor
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Voice sounds heard clearly via the stethoscope?
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Bronchophony
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eeeee to AAAAA sound
Can be a sign of what? |
Egophony
-consolidation |
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Very deep and labored breathing with normal or reduced frequency, seen in severe acidosis?
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Kussmals
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Abnormal pattern of breathing characterized by oscillation of ventilation between apnea and hyperpnea to compensate for changing serum partial pressures of oxygen and carbon dioxide. Often seen in brain damage.
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Cheyne Stokes breaths
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Pursed lips breathing is often seen in what patients?
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COPD
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What condition is characterized by SOB and pleuritic pain, and on physical exam there may be tracheal deviation, diminished expansion on affected side, diminished breath sounds, and hyperrrosonance with percussion?
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Pneumothorax
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-Productive cough w/purulent sputum and SOB and chest pain
-fever, tachypnea, and tachycardia -dimished breath sounds & dullness to percussion of affected lobe -Positive egophony All suggest what? |
Lobar Pneumonia
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Symptoms:cough, dyspnea, hemoptysis, weight loss, anorexia, fatigue, CP, muscle weakness, cofusion or memory loss
Signs:lobar consolidation, localized wheezing, pleural effusion, tracheal shift, cachexia, lymphadenopathy, hepatomegaly, ascites, and clubbing All suggest what? |
Lung Cancer
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How do you get evaluated pulse pressure?
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Systolic - diastolic
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S1 is best heard where?
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over apex with diaphragm
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S1 is made by what valves closing?
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Mitral and Tricuspid
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S2 is best heard where?
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left upper sternal border over base of the heart
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S2 is made by the closure of what valves?
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Aortic and Pulmonic
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S1 is louder in what conditions?
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-mitral stenosis
-short PR interval -tachycardia |
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S1 is softer in what conditions?
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-long PR interval
-acute aortic regurgitation |
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How do you get Mean Arterial Pressure (MAP)?
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Diastolic plus 1/3 pulse pressure
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Apical impulse that is more virogous than normal?
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heave/lift
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A fine, palpable, rushing vibration; a palpable murmur?
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Thrill
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Auscultated arterial murmur (turbulent flow)
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Bruit
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Sound heard when two surfaces are rubbed together?
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Friction Rub
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What are some Diastolic Murmurs?
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-Aortic insufficiency
-Mitral Stenosis |
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What are some systolic murmurs?
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-Aortic Stenosis
-Mitral insufficiency -MVP -Tricuspid Insufficiency |
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What is Cullen's sign?
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A bluish discoloration around the umbilicus
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What is Grey Turner's sign?
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A bluish discoloration of the flanks that may be a sign of pancreatitis.
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Cullen and Grey Turner's sign my occur in what condition?
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Hemoperitoneum
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What is borborygmi?
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prolonged loud gurgles that occur with gastroenteritis, early intestinal obstruction, or hunger.
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What can cause hypoactive bowel sounds?
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-Peritonitis
-Paralytic ileus -anesthesia -decreased appitite |
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Murphy's sign is used to test for what?
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Cholecystitis
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What signs can be used to test the appendix?
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-Psoas Sign
-Obturator Sign -McBurney's Point |
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-Localized or diffuse RUQ pain
-Radiation to right scapula -Vomiting and constipation -Low grade fever All indicate what condition? |
Acute Cholecystitis
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-Sever flan pain-intermittent
-Radiation to groin and genitals -Vomiting and urinary symptoms -Hematuria -positive Kehr's sign. |
Renal Colic
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What is Kehr's sign?
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Pain radiation to the left shoulder that is seen in Renal colic or speen rupture
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-Ascites
-Jaundic/Icterus -Non-palpable liver -Caput Medusa -Gynecomastia -Testicular Atrophy All indicate what? |
Cirrhosis
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What is the order of the abdominal exam?
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-Inspection
-Auscultation -Percussion -Palpation |
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Black or tarry stool can indicate what disease?
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ulcer
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Bright Red blood Per Rectum can indicate what diseases?
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-hemmroids
-fissure -diverticulosis |
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What are some causes of Prostatitis?
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-STD
-Bacterial |
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A pencil stool can indicate what disease?
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Rectal Cancer
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Phren's Sign can be seen in what disease?
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-Orchitis
-Epidimitis |
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What is Phren's sign?
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Pain relief on scrotal elevation
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The following signs indicated what disease?:
-bacterial infection -Teens to adults -gradual onset of pain -fever -dysuria, pyuria -Redness of scrotum -Urethral discharge -Nodular epididymis |
Epididymitis
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What is paraphimosis?
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when you can't put the foreskin back in place
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What is phimosis?
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when you can't retract the foreskin
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Inflammatory disoder of the uterus, fallopian tubes, and adjacent pelvic structures?
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PID
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Cervical motion tenderness is associated with what condition?
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PID
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What are the two main types of cervical cancer?
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-Squamous Cell
-Adenocarcinoma |
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What are some symptoms of cervical cancer?
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-Abnormal bleeding
-Pap and biopsy |
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What are some risk factors for cervical cancer?
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-intercourse at early age
-multiple sex partners -smoking -STDs |
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Tell me about Fibrocystic Disease?
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-most common palpable mass
-associated with menstration -pain in UOQ -tender mass -usually bilateral -rubbery diffuse lumpiness on exam |
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-Benign solid mass on breast
-usually nontender -< 30 y/o -can grow w/hormonal influence, primarliy during pregnancy -best visualized by ultrasounds -Fine Needle aspiration to confirm binign mass. |
Fibroadenoma
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Enlargement of one or more lymph nodes as a result of normal reactive effects or a pathologic occurence?
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Lymphadenopathy
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An edema score of 1+ means what?
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mild pitting, slight indentation
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An edema of score of 2+ means what?
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moderate pitting, indentation subsides rapidly
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An edema score of 3+ means what?
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deep pitting to 6mm, remains for a short time after pressure applied
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An edema score of 4 plus means what?
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Deep pitting >6mm, legs is very swollen
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