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