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124 Cards in this Set
- Front
- Back
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Give part of the case history
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1. family
2. social and environment 3. previous diseases 4. present complaints 5. others |
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Give parts of physical examination
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1. inspection
2. palpation 3. percussion 4. auscultation |
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What is subfebrility?
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body temperature is between 37-37.5
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What is fever?
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body temperature > 37.6
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What are causes of fever?
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1. infectious disease
2. necrosis 3. damage of heat center 4. heat congestion 5. immune diseases 6. metabolic diseases |
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What is febris continua?
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1. Continuously high fever
2. daily difference of temperature is less than 1 |
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What is febris remittent?
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1. Changing fever
2. Daily changes are higher than 1.5 3. minimum temperature is continuously higher than 37 |
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What is febris intermittens?
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1. alternating fever
2. daily changes are higher than 1.5 3. minimum temperature is normal |
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Give the ideal body weight using Broca's fomula?
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Ideal weight = height (cm) - 100
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What should be examined by macroscopic analysis of sputum?
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1. quantity
2. color 3. odor 4. consistency |
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What is eupnoe?
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1. number of breathing is 16-18 times/min
2. symmetrical distension of thorax |
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What is tachypnoe?
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1. Frequent breathing
2. number of breathing >18times/min |
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Give basic examination of pulmonary diseases?
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1. Physical examination
2. radiological laboratory and morphological examinations 3. functional tests |
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Basic rules of auscultation of the lungs?
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1. comparative auscultation on both sides of the same places
2. First the apical, then middle, then supradiaphragmic regions should be examined 3. in cases of bronchial murmurs, the pathological regions should be auscultated before and after coughing. Wheezing can be examined without stethoscope if patient is breathing with opened mouth |
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Percussion sound of the lung of a healthy man?
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1. sharp
2. full 3. not tympanic |
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Give the borders of the lungs of a healthy man
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1. right front in mid clavicular line at lower edge of rib 6
2. both sides, mid clavicular lines at rib 8 3. both sides, at scapular lines of rib 9 4. both sides of paravertebra, the spinous process of veterbra 11 |
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What should be considered while percussing the thorax?
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1. ideal position of patient
2. do not percuss on bone 3. percussion sounds may differ in each region of the thorax |
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Give forms of the cardiac dyspnoe?
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1. excercise induced
2. rest dyspnoe 3. orthopnoe (while lying flat) 4. paroxymal dysnpnoe (sudden, shortness breath at night) |
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What is tachycardia?
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frequency of pulse > 100/min
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What is bradycardia?
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frequency of pulse < 60/min
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Difference between central and peripheral cyanosis?
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1. central: generalized and warm extremities
2. peripheral: localized and cold extremities |
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Borders of relative heart dullness?
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1. upper border: parasternally the upper edge of rib 3
2. left border: apex beat or 1 finger medial from left mid. clavicular line 3. right border: right edge of sternum |
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Cause of I heart sound?
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1. closure of mitral and tricuspid valves
2. sound of heart muscle |
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Cause of II heart sound?
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Closure of aortic and pulmonary valves
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Cause of III heart sound?
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Filling sound
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Cause of IV heart sound?
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Presystolic sound (atrial)
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When will III sound be louder?
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Volume overload of heart
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Give the parts of a patient's chart
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1. Administrative part (patient's data)
2. case history 3. physical examination 4. laboratory data 5. radiological, histological results 6. epicrisis |
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When is mesosystolic murmur audible?
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At the middle of systole
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When is holosystolic murmur audible?
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In the entire systole
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Cause of IV heart sound?
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Presystolic sound (atrial)
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When will III sound be louder?
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Volume overload of heart
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When is protosystolic murmur audible?
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At the beginning of systole
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When is mesosystolic murmur audible?
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At the middle of systole
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When is presystolic murmur audible?
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At the end of diastole, just before systole
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What is the gallop rhythm?
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1. III, IV sound or both become stronger
2. their intensity will be the same as I and II sound's |
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What is the organic endocardial murmur?
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Cause by structural change in:
1. big blood vessels 2. valves 3. orifices |
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Give borders of the heart on a postero-anterior x-ray picture?
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1. Left side: Aorta, pulmonary a., left atrium, left ventricle
2. right side: Aorta, SVC, right atrium |
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Give the palpable arteries on the lower extremities?
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1. Femoral a.
2. popliteal a. 3. posterior tibial a. 4. dorsalis pedis |
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What's the pulse deficit?
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1. the frequency of the heart is higher than peripheral pulse
2. the difference between 2 data |
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Give characteristics of the pulse
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1. frequency
2. rhythmicity 3. altitude 4. velocity 5. equality 6. compressibility |
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What's Homans test?
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1. low extremity is bended
2. rapid dorsal flexion causes pain in the leg's muscles |
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Give regions of the abdomen
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1. 2 hypochondrium
2. epigastrium 3. 2 lumbar 4. umbilical 5. 2 inguinal 6. pubic/hypogastrium |
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What to exam by superficial palpation of the abdomen?
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1. tension of the muscles
2. diffuse or circumscribed muscle defence |
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What does the disappearance of liver dullness indicate?
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Air in the abdominal cavity due to perforation of stomach or gut
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Where is the normal border of the spleen?
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1. between rib 9 and 11
2. between middle and anterior axillary line |
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What is pollakiuria?
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1. pain and urgency at urination
2. frequently small amount of urine |
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What is anuria?
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Daily urine < 100ml
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What is oliguria?
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Daily urine > 500ml
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The analysis of urine means the following examinations:
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1. Sugar
2. Urobilinogen 3. Protein 4. Acetone content 5. Bilirubin content 6. Osmolarity 7. Microscopic examination of the sediment |
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What does clearance indicate?
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The excretion of a particular material by kidney in 1 minute
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What is proteiuria?
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Detectable amount of protein in urine
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What is pyuria?
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Detectable leukocyte in urine
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What is bacteriuria?
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Detectable bacteria in urine (>1million/ml)
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Give examinations which indicate the tubular functions of the kidney
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Dilution and concentration capacity of kidney:
1. pH 2. excretion 3. phosphate 4. glucose reabsoprtion 5. excretion of amino acids and sodium |
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What is microscopic hematuria?
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RBC in urine sediment
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Give characteristic of glomerular hematuria
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RBC of different size and shape in sediment of the urine
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What is diagnosis?
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The process to identify the disease
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What is differential diagnosis?
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Differential diseases from each other
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What is stimulation?
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Healthy patient pretends to be sick
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What is aggravation?
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worsening of an existing sickness/symptom
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What is dissimulation?
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Neglecting/diminishing complaint/symptom
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Give the theoretical outcomes of a disease?
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1. Complete recovery
2. partial recovery 3. relapse 4. death |
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Give the different stage of disease?
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1. Latency period: from the beginning of the disease until the complaints developed
2. Morbid stage: from the appearance of complaint/symptoms till their disappearance 3. Recovery |
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If the patient complains about pain, you must determine the followings:
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1. location
2. quality 3. quantity 4. time-relation 5. the setting in which it occurs 6. factors that make it better or worse 7. associated symptoms |
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Orthopnoe suggests:
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1. left ventricle failure or mitral stenosis
2. obstructive lung disease |
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Give the location of pain caused by myocardial infraction
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1. retrosternal
2. radiate to shoulders, arms, neck, lower jaw (mainly left side) or epigastrium |
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Give the location of pain caused by pericarditis
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precordial
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Give the location of pleural pain
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Chest wall overlying the process
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Give the location of pain caused by reflux esophagitis
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1. Retrosternal
2. may radiate to the back |
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Give the location of pain caused by dissecting aortic aneurism
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1. anterior chest
2. radiating to neck, back, abdomen |
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Give the location of pain caused by tracheobronchitis
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1. upper sternal
2. parasternal |
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Describe bitemporal hemianopsia
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Visual loss of temporal half of each field
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Describe homonymous hemianopsia
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1. visual loss in both eyes are homonymous (similar)
2. involve half of each field |
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Give the middle clavicular line
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vertical from the midpoint of the clavicle
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Give the anterior axillary line
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vertical from the anterior axillary fold
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Give the scapular line
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vertical from the inferior angle of the scapula
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Give the characteristics of vesicular breath sounds
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1. low, soft inspiratory sound
2. locate over the lung fields away from the trachea and large bronchi |
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The potential use of palpation of the thorax are:
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1. identification of tender area
2. assessment of observed abnormalities 3. further assessment of respiratory expansion 4. assessment of tactile fremitus (palpable vibration) |
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Describe added sounds in left side heart failure
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1. crackle at lung base
2. sometimes wheezes |
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Describe added sounds in lobar pneumonia
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crackles
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For purpose of description, female breast is divided into:
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1. upper inner
2. upper outer 3. lower inner 4. lower outer |
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What is claudicatio intermittens?
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1. At walking for a certain distance, crampy pain in the leg
2. disappears after rest |
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What does the Perthes' test inform about?
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1. stage of venae perforantes
2. permeability of the deep veins |
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What is the difference between transsudatum and exsudatum?
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1. Protein content of transsudatum: 1-2%
2. exudate: 4% |
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What is vital capacity?
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Amount of maximally expired air after a deep inspiration
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Where can the aortic valve be auscultated?
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1. Right edge of sternum
2. at 2nd intercostal space |
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Where is the pulmonary vavle auscultated?
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1. Left edge of sternum
2. 2nd intercostal space |
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Where is mitral valve auscultated?
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1. above apex of the heart and left edge of sternum
2. at 4th intercostal space |
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Give the lines which demarcate different regions of the abdomen
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1. 2 medioclavicular lines
2. subcostal line 3. interspinal line |
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What is meteorism?
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Elevated anterior wall of the abdomen due to increased gas content of the bowels
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Give the causes of symmetric elevation of the abdominal wall?
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1. Obesity
2. meteorism 3. acites 4. pregnancy 5. fill urinary bladder |
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What is hernia?
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1. Congenital or acquired weakness or ruption of abdominal wall
2. Due to increased intraabdominal pressure, the content (bowels, greater omentum) protrudes foward the abdominal peritoneum |
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What is the normal male and female umbilical hair like?
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1. Male: above mons pubis: convex borderline, may grow up to the umbilicus
2. Female: above mons pubis : horizontal sharp border |
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What is Rowsing's sign?
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1. Press deeply in lower left quadrant of abdomen then quickly withdraw; the patient has pain in right lower quadrant during the press
2. suggest appendicitis |
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Where should the abdominal puncture be made?
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1. in the left iliac region
2. divide the line between umbilicus and anterior superior iliac spine into 3 equal parts 3. puncture at the border between the lateral and medium segments (opposite to McBurney's point) |
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What is edema, give its types and location
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Edema: increase of interstitial fluid
Type: generalized or local 1. cardiac edema: according to gravitation ( feet, legs, sacral) 2. renal edema (periorbital - generalized) 3. hypo-proteinaemic edema (generalized) 4. deep vein thrombosis (og the affected extremity) |
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How should the Babinsky's test be carried out and evaluated?
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1. stroke the lateral aspect of the sole (with moderately sharp object) from the heel to the ball of the foot, curving medially across the ball
2. Lightest stimulus will provoke a response 3. dorsalflexion of big toe amd fanning of other (possitive sign) indicate upper motor neuron disease |
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What should be examined on the pupils?
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1. are they round, symmetric, sharp edge, cnetral?
2. their consensual reaction to light and convergention |
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Give the hypnoid mental lesions
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1. somnolence
2. sopor 3. coma |
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Which are the most frequently tested reflexes on the upper extremities?
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1. radius
2. ulnar 3. biceps 4. triceps |
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Which are the most frequently tested reflexes on the lower extremities?
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1. patella
2. achilles |
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Give the characteristics of meningeal agitation
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1. vomitus
2. nausea 3. fixed occiput 4. bradycardy 4. Brudzinki and Kernig's positivity |
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Technique of investigation of Laseque sign?
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1. Patient lying on his back
2. feels pain when elevating his leg to 90 degree |
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Give different forms of palpation
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1/ superficial
2. medium deep 3. deep 4. bimanual 5. balloting |
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How an intraabdominal resistance should be characterised?
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1. location
2. shape 3. surface 4. consistency 5. mobility 6. tenderness 7 following breathing or not 8. fixed to its environment or not |
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What is the percussion sound of the abdomen like?
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tympanic
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Give border of the liver
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right side in medioclavicular line from lower edge of rib 6 till the costal margin
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What is hematemesis?
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Vomiting blood
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What is melena?
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digested blood in stool
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What is hematochesia?
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fresh blood in stool
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What is acholic stool like?
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1. grayish-white
2. shiny (due to bile duct obstruction) |
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What is hyperemesis?
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Extensive vomiting
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How should the spleen be examined?
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1. patient lies on his right side
2. left arm over head |
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What is subicterus?
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1. slight jaundice
2. icteus of sclera is detacble 3. concetration of bilirubin ~ 30 micromol/l |
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What is the McBurney's point?
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1. right iliac region
2. devide the line between umbilical and the anterior upper iliac spine into 3 equal parts 3. at the border of laterla and medium segment (opposite to the abdominal puncture site) |
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Which articulations are most frequently effected by gout?
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The metacarpophalangeal articulation of the big toe
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Give the functions of CNI-III
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1. sense of smell
2. vision 3. pupillary constriction 4. elevation of upper eyelid and extraocular movements (mostly) |
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Give the normal concetration of serum Na.
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137-145 mmol/l
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Give the normal concentration of serum Potassium
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3.5-4.5 mmol/l
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Give the normal concentration of serum glucose
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3.6-6.0 mmol/l
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Give the normal concentration of WBC
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4.8-9.0 G/l
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Give the normal concentration of hemoglobin
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120.0-150.0 g/l
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