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103 Cards in this Set

  • Front
  • Back
why is history taking important?
it establishes communication with patient
requires communication
Can physicians say sorry?
yes
why are open ended questions important?
these help allow a patient to expand on information
what are the advantages/disadvantages of open ended questions?
advantage, allow pt to provide detailed information
disadvantage- pts can ramble
what is the cheetos factor
use clues to figure out family situations and socioeconomic factors that can influence health
What are the portions of a history?
CC-chief complaint
HPI- history of present illness
PMH-past medical history
FH- family history
SH- social history
MEDS-
ALLERGIES
ROS- review of symptoms
What is the acronym used for HPI taking? and what does it mean?
COLDERASS
Character, Onset, Location, Duration, Exacerbating factors, Relieving factors, Associated Signs and Symptoms
what does SOAP stand for?
Subjective, Objective, Assessment, Plan
What is the subjective, and what is the objective?
Subjective is what patient says
Objective is findings
What are the main diagnostic techniques?
Inspection
Palpation
Percussion
Auscultation
What is the standard oral temp?
98.6F (37c)
How do the other temperatures differ from the standard oral temp?
rectal= .7-.9F higher
tympanic 1.4F lower
Axillary 1.5-2F low
What is normal BP D/S range?
120/80
What is the chriteria for prehypertension?
120-139 Systolic OR 80-89 Diastolic
what is the chriteria for Hypertension?
greater than 140 Systolic OR greater then 90 Diastolic
What is malignant hypertension?
Diastolic Greater than 120!
In order to diagnose hypertension, how far apart do two readings need to be?
3 weeks
How long should a BP cuff be?
the length of the BP cuff should be 80% of the width of the arm, and 40% of the circumference
What is CN V? how is it tested?
this is tested with light touch on the face (trigeminal nerve)
What does CN VII do? how is it tested?
this is the making facial expressions nerve
what is caput succedanum?
this is swelling that crosses midline
what is cephalohematoma?
this a bleed above bone, beneath periostium, does NOT cross midline
What does CN IX do? how is it tested?
tested by saying AH!
has motor to parotid gland
has sensory to taste buds
What does CN X do, and how is it tested?
Say AH!
motor to pharynix/layrinx
sensory to pharynx/larynx
where are the frontal sinuses found?
paired, in the frontal bone above eyebrows
where are the ethmoid sinuses found?
these line the nose in patches
where are the sphenoid sinuses found?
in the outer corners of the eye
What does Jugular Venous Distension indicate?
Right artrium not allowing proper venous return
What is torticollis?
this is sternocleidomastoid hypertonicity
What are the signs of Cushing Syndrome?
Obesity, Buffalo Hump, Round face. Caused by Cortisol overproduction
What are the signs of Systemic Lupus Erythmatosus?
Butterfly rash, fever, rash, arthritis, anemia
What do Myxedema facies look like? what causes them?
serious hypothyroidism
dry skin/ hair
firm/inelastic edema
loss of physical/mental vigor
What are the signs of hyperthyroidism?
goiter (thyromegaly)
proptosis- (bulging eyes)
what is proptosis?
bugging out of the eyes caused by hyperthyroidism
What are the signs and cause of Acromegaly?
Large facial bones, Large hands feet
Caused by Excessive HGH production
What are the signs and causes of Bells palsy?
drooping of 1 side of face CN VII paralysis.
idopathic. can cause problems from not being able to close eye.
Can also see flattened nasolabial fold
what are the signs and causes of downs syndrome?
upslanting palpebreal fissures (near eyes), protruding tounge
Caused by trisomy 21
What are the signs of Hyperthyroidism?
Goiter, sensitive to heat (too much energy production), Increased heart rate, Diarrhea, No period, Muscle weakness, weight loss, warm skin, Proptosis
What the signs of Hypothydroism?
NO goiter, Sensitve to cold, puffy eyes, consitpation, heavy periods, weight gain, scaly skin
What are the 3 criteria for Fetal Alcohol syndrome?
-Retarded Growth (below 10th percentile) - Low Wt/Height ratio
-Brain Malformation (below 10th percentile in head circumference)- structrual abnormalities
-Minor Facial abnormalities (thin upper lip, flat midface, no valley between nose and upper lip)
What nerve does the corneal reflex?
Branch V1 of CN 5 (trigeminal nerve) (the light touch guy)
Which is responsible for most of the refraction of light, the lens or cornea?
the cornea
What does the lens do?
this fine tunes the refraction of light
What is presbyopia?
this is old eyes, lens becomes flattened and hardened, loss of close vision
What is CN II?
optic nerve, leaves eye via optic disk
What is CN III?
this is ocular motor nerve, controls eye movement and papillary constriction
What is CN IV?
this supplies the Superior Oblique of the eye
What are the 3 branches of CN V?
V1- opthomalic (eye poke test)
V2- maxillary sensory
V3- sensory and motor to masseter
What does CN VI do?
This the the Lateral movement of the eye LR6SO4AO3
What does CN VII do?
this is the facial nerve, provides motor/sensory. Motor tested by making faces
What are the 3 Eye muscles we need to know? (groups)
LR6 SO4 AO3
Lateral Rectus CN 6
Superior Oblique CN 4
All others CN 3
What are the relative sizes and ratios of arteries and veins in the eye?
Veins are bigger, and more numerous by 2:1
What is papilledema and what are its signs and causes
This is a swelling of the optic disk caused by intracrainal pressure.
-Typically bilateral
blurred optic disk margins
filling in of optic disk cup
congestion of retinal veins
peripapillary hemorrhages
What is hypertensive retinopathy, and what causes it?
This is caused by high BP,
Signs-
aterioslcerotic changes
arteriolar narrowing that is bilateral
AV nicking
Ischemic changes "cotton wool spots"
hemorrhages that are often flame shaped
Edema- ring of extudates around the retina called "macular star"
What does CN IX affect?
this has motor to the parotid gland (big salavary gland)
and sensory to posterior oral pharynx, as well as taste of posterior 1/3 of tounge
What nerves injury would prevent a patient from speaking?
CN X vagus, and its recurrent laryngeal branches
What does CN XII do?
this supplies motor to all of the tounge
Why are children more prone to ear infections than adults?
because of their more horizontal eustachian tubes
When does the frontal sinus develop?
7-8 years of age
when do baby (deciduous) teeth appear?
6-24 months
when do permanent teeth appear?
6-15 years
What is Battles sign?
this indicates a basilar skull fracture, it is brusing behind the ear
What two structures are you supposed to be able to see in the ear?
Cone of light, and the umbo, which is the bone in the ear
What test compares air conduction vs. bone conduction for hearing loss?
Renne vs. Weber.
What does otius externa look like?
this is an infection of the ear canal
what does otitus media look like?
this is accumulation of junk behind the ear drum, infection of inner ear. typmanic membrane looks like it has junk behind it
What does APGAR stand for?
Appearance, Pulse, Grimace, Activity, respiration
How is apgar scored?
This rates the baby from 0-2 pts per category
goes like NONE- SOME - LOTS
aka, no cry, weak cry, vigorus cry
and No tone, weak flexion, well developed flexion
When is a child considered pre mature?
less than 37 weeks
when is "term" for birth?
38-42 weeks
how old is post mature child?
greater than 42 weeks
What is the ballard score used for?
estimating gestiational age
When is a child small for gestational age?
birth weight lower than 10th percentile, or less than 2500g
what can cause a child to be small for gestational age?
starvation, hypoxia, drug use, drug exposure (all from mother)
when is a child large for gestational age?
above 3800g, or above 90th percentile
what the the risk factors for a child being large for gestational age?
moms being fat/diabetic, male fetus, prolonged gestation
what is pectus excavatum?
the most frequent chest wall deformity, concave depression of chest
what is pectus carinatum?
this is less common, a protrusion of sternum and costal cartilages
what is milla?
these are small pearly white bumps on the skin of new borns
what are hemangiomas?
these are benign tumors/ vascular malformations of endotheial cells
what is lanugo?
this is body hair on new borns
what are mongolian spots?
melanin staining birthmarks, with wavy borders, and irregular shape
what is erythema toxicum?
this is a rash on newborns
what are epsteins pearls?
these are small white/ cystic papules on lips or roof of mouth in newborns
what is metatarsus varus?
this is adduction and inversion of metatarsal bone (toeing in)
what is talipes equinovarus?
club foot
what does the barlow test show? how does it work?
this tests the dislocatability of the hip with ADDUCTION
what does the ortolani test show, and how does it work?
this test the relocatability of the hip into the socket, with ABDuction
What are the 4 special newborn reflexes?
Moro
Placing and Stepping
Grasp
Root
What is moro's reflex?
tilt head back, and babys arms swing out and fingers open up
When are well child visits?
2-4 weeks
2,4,6,9,12,15,18,24 months
what shot do babies get before leaving the hospital?
hep B
what is Miosis?
pupillary constriction
what is Mydriasis?
pupillary dilation
what is anisocria?
unequal pupil size
what is anhidrosis?
not sweating
what is horners syndrome?
This is a interruption in the sympathetic nervous system
What causes Horners syndrome? what characterizes it?
This is an interruption of the sympathetic nervous system, characterized by =
Anhydrosis (no sweating)
Miosis (constricted pupils)
Ptosis (sagging upper eyelid)
What is a chalazion?
An inflamed gland that points inward on the lower eyelid. CHRONIC!
what is a hordeolum (stye)
this is a infection near hair follicle of eyelashes, like a pimple. Not chronic, can scar and become a chalazion
what is a pingueculum?
this is a yellow node on the eyeball itself, that can appear with aging, should not interfere with vision
From bulbar conjuctiva
what is a pterygium?
this is a thickening of the bulbar conjuctiva that grows across the eye and imparis vision
what is hyphema?
blood in the anterior chamber of the eye (bad)