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122 Cards in this Set

  • Front
  • Back
1.Give the parts of case history
Social and environmental
Previous diseases
Present complaints
Other questions
2.Give the parts of physical examination
3.What is subfebrility?
The temperature of the body is between 37 C – 37.5 C
4.What is fever?
The temperature of the body is higher than 37.6 C
5.What are the causes of fever?
infectious disease
damage of the heat centre
heat congestion
immune diseases
metabolic diseases
6.What is febris continua?
Continuously high fever, the daily difference of temperature is less than 1oC
7.What is febris remittent?
Changing fever, the daily changes are higher than 1.5 oC, the minimum temperature is continuously higher than 37oC
8.What is febris intermittens?
Alternating fever, the daily changes are higher than 1.5oC, the minimum temperature is normal
9.Give the ideal body-weight using Broca,s formula
Ideal weight = height (in cm) – 100
10.What should be examined by macroscopic analysis of the sputum?
11.What is eupnoe?
The number of breathing is 16-18/min, with symmetric distension of the thorax
12.What is tachypnoe?
Frequent breathing
The number of breathing > 18/min
13.Give the basic examinations of pulmonary diseases
Physical examination
Radiological laboratory and morphological examinations
Functional tests
14.Give the basic rules of the auscultation of the lungs
Comparative auscultation on both sides on the same places
First the apical regions, then the middle parts and finally the supradiaphragmic regions of the lungs should be examined
In case of bronchial murmurs the pathological regions should be auscultated before and after coughing. Wheezing can be examined without phonendoscope if the patient is breathing with opened mouth
15.Percussion sound of the lung of a healthy man
Sharp, full, not tympanic
16.Give the borders of the lungs of a healthy man
Right front in the medioclavicular line at the lower edge of the 6th rib
Both sides, in the medioclavicular line at the 8th rib
Both sides in the scapular line at the 9th rib
Both side paravertebral the processus spinosus of the 11th vertebra
17.What should be considered while percussing the thorax?
Ideal position of the patient
Do not percuss above bones
The percussion sound may differ at different regions of the thorax
18.Give the forms of the cardiac dyspnoe
Exercise induced
Rest dyspnoe
Paroxysmal dyspnoe
19.What is tachycardia?
The frequency of pulse is over 100/min
20.What is bradycardia?
The frequency of pulse is lower than 60/min
21.What is the difference between central and peripherial cyanosis?
The central one is rather generalized and the extremities are warm
The peripherial one is localised and the extremities are rather cool
22.Give the borders of the relative heart dullness
Upper border: parasternally the upper ridge of the 3rd rib
Left border: The apex beat or 1 finger medial from the left medioclavicular line
Right border: The right edge of the sternum
23.What is the cause of the I. heart sound?
The closure of the mitral- and tricuspidal valves and the sound of the heart muscle
24.What is the cause of the second heart sound?
The closure of the aortic and pulmonary valves
25.What is the third sound?
The filling sound
26.What is the fourth sound?
Praesystolic sound (atrial)
27.In which case will the third sound be louder?
In case of volume overload of the heart
28.When is the protosystolic murmur audible?
At the beginning of the systole
29.When is the mesosystolic murmur audible?
At the middle of the systole
30.When is the holosystolic murmur audible?
The murmur is audible at the entire systole
31.When is the praesystolic murmur audible?
At the end of the diastole just before the systole
32.What is the gallop rhythm?
Either the III. or the IV. sound or both become stronger and their intensity will be the same as that of the intensity of the I. or II. sound
33.What is the organic endocardial murmur?
The murmur is caused by structural changes of the big blood vessels, valves, or orificiums
34.Give the characteristics of murmurs
In which phase of the heart function does it appear
Where is the punctum maximum
Propagation of the murmur
35.Give the borders of the heart on a postero-anterior x-ray picture
Left side: from up downward. Aorta, art.pulmonalis, left atrium,left ventricle
Right side: from up downward aorta, vena cava superior, right atrium
36.Give the palpable arteries on the lower extremities
Art. femoralis
Art. poplitea
Art. tibialis posterior
Art. dorsalis pedis
37.What is the pulse deficit?
The frequency of the heart is higher than that of the peripheral pulse. The difference between the two data is the pulse deficit
38.Give the characteristics of the pulse
39.What is the Homans, test?
Low extremity is blended, a rapid dorsalflexion causes pain in the muscle of the leg
40.Give the regions of the abdomen
Two ( righ and left) hypochondrium
Two (right and left) lumbar
Pubic( hypogastrium)
Two (right and left) inguinal
41.What is to be examined by superficial palpation of the abdomen?
The tension of the abdominal muscles, diffuse or circumscribed muscle defence
42.What does the disappearance of the liverdullness indicate?
Air in the abdominal cavity due to perforation of the stomach or gut
43.Where is the normal border of the spleen?
Between the IX.-XI. ribs, between the anterior and medial axillary line
44.What is pollakisuria?
Pain and urgency at urination, frequently a small amount of urine
45.What is anuria?
The amount of the daily urine is less than100 ml
46.What is oliguria?
The amount of daily urine is less than 500 ml
47.The analysis of urine means the following examinations
Specific gravity - osmolality
Aceton content
Bilirubin content
Microscopic examination of the sediment
48.What does the „clearance” indicate?
The excretion of a particular material by the kidney during 1 min
49.What is proteinuria?
Detectable amount of protein in the urine
50.What is pyuria?
Detectable leucocytes in the urine
51.What is bacteriuria?
Detectable bacteria in the urine (10^5/ml or more)
52.Give the examinations which indicate the tubular functions of the kidney
Dilution and concentration capacity of the kidney: pH, excretion, phosphate, glycose reabsorption, excretion of amino acids and sodium
53.What is microscopic haematuria?
Red blood cells in the urine sediment
54.Give the characteristic of glomerular haematuria
Red blood cells of different size and shape in the sediment of the urine
55.What is diagnosis?
The process to indentify diseases
56.What is differential diagnosis?
Differentiation of diseases from each other
57.What is simulation?
The healthy patient pretends to be sick
58.What is aggravation?
Aggravating of an existing sickness - symptom
59.What is dissimulation?
Neglecting or diminishing complaints, symptoms
60.Give the theoretical outcomes of a disease
Complete recovery
Partial recovery
61.Give different stages of disease
Latency period from the beginning of the disease till the development of complaints
Morbid stage (from the appearance of signs and symptoms till their disappearance)
62.Give the parts of a patient's chart
Administrative part (data of the patient)
Case history
Physical examination
Laboratory data
Radiological, histological… results
63.How free air in the abdomen can be diagnosed?
By the disappearance of the dullness of the liver
64.If the patient complains abouth pain you must determine the followings:
Quantity or severity
The setting in which it occurs
Factors that make it better or worse
Associated symptoms
65.Orthopnoe suggests:
Left ventricular failure or mitral stenosis
Obstructive lung disease
66.Give the location of pain caused by myocardial infarction
Retrosternal, sometimes radiating to the shoulders, arms, neck, lower jaw (mainly left side) or epigastrial
67.Give the location of pain caused by pericarditis
68.Give the location of pleural pain
Chest wall overlying the process
69.Give the location of pain caused by reflux esophagitis
Retrosternal, may radiate to the back
70.Give the location of pain caused by dissecting aortic aneurism
Anterior chest, radiating to the neck, back or abdomen
71.Give the location of pain caused by tracheobronchitis
Upper sternal or on either side of the sternum
72.Describe bitemporal hemianopsia
The visual loss involves the temporal half of each field
73.Describe homonymous hemianopsia
The visual loss in both eyes is similar (homonymous) and involves half of each field (hemianopsia)
74.Give the midclavicular line
Vertical from the midpoint of the clavicle
75.Give the anterior axillary line
Vertical from the anterior axillary fold
76.Give the scapular line
Vertical from the inferior angle of the scapula
77.Give the characteristics of vesicular breath sounds
Low, soft, inspiratory sound, located over the lung fields away from the trachea and large bronchi
78.The potential use of palpation of the thorax are:
Identification of tender areas
Assessment of observed abnormalities
Further assessment of respiratory expansion
Assessment of tactile fremitus
79.Describe added sounds in left side heart failure
Crackles at lung bases, sometimes wheezes
80.Describe added sounds in lobar pneumonia
81.For purposes of description, the female breast is divided into the following regions
Upper inner
Upper outer
Lower inner
Lower outer
82.What is claudicatio intermittens?
At walking, after a certain distance, crampy pain in the legs, which disappears after rest
83.What does the Perthes,s test inform about?
About the stage of venae perforantes and the permeability of the deep veins
84.What is the difference between transsudatum and exsudatum?
Protein content of transsudatum is: 1-2g%, while that of exsudatum is more than 4g%
85.What is vital capacity?
The amount of maximally expired air after a deep inspiration
86.Where can the aortic valve be auscultated?
Right edge of the sternum at the second intercostal space
87.Where is the pulmonary valve auscultated?
Left edge of the sternum at the second intercostal space
88.Where is the mitral valve auscultated?
Above the apex of the heart and left edge of the sternum at the IV. intercostal space
89.Give the lines which demarcate different regions of the abdomen
Two medioclavicular lines the subcostal line and the interspinal lines
90.What is meteorism?
Elevated anterior wall of the abdomen due to increased gas content of the bowels
91.Give the causes of the symmetric elevation of the wall of the abdomen?
Obesity, meteorism, ascites, pregnancy, filled urinary bladder
92.What is hernia?
Congenital or acquired weakness or ruption of the abdominal wall (muscles). Due to increased intraabdominal pressure the content of the abdominal cavity (bowels, omentum maius) protrudes pushing forward the abdominal peritoneum
93.What is the normal male and female umbilical hair like?
Mail: above the mons pubis convex border line, may grow up to the umbilicus. Female: above the mons pubis a horizontal sharp border
94.Give different forms of palpation
Superficial, medium deep, deep, bimanual and balloting
95.How an intraabdominal resistance should be characterised?
By localisation, shape, surface, consistency, mobility, tenderness. Whether it follows the breathing or not, whether it is fixed to its environment or not.
96.What is the percussion sound of the abdomen like?
97.Give the borders of the liver
Right side in the medioclavicular line from the lower edge of the VI. rib till the costal margine
98.What is haematemesis?
Vomiting blood
99.What is melena?
Digested blood in the stool (tar-like stool)
100.What is haematochesia?
Undigested blood in the stool
101.What is acholic stool like?
Greyish-white, shiny (due to the obstruction of the biliary ducts)
102.What is hyperemesis?
Extensive vomitus
103.How should the spleen be examined?
The patient lies on his right side, left arm over the head
104.What is subicterus?
Slight jaundice. Icterus of the sclera is detectable, concentration of bilirubin about 35 umol/l
105.Where is the McBurney,s point?
In the right iliacal region, we divide the line between the umbilicus and the right spina iliaca anterior superior into 3 equal parts, - at the border of the lateral and medium segment
106.What is Rowsing,s sign?
Press deeply in the left lower quadrant of the abdomen then quickly withraw your fingers pain in the right lower quadrant during left sided pressure suggests - appendicitis
107.Where should the abdominal puncture be made?
In the left iliacal region, we divide the line between the umbilicus and the spina iliaca anterior superior into 3 equal parts, at the border of the lateral and the medium segment
108.What is edema, give its types and localisation
Increase of the interstitial fluid
Generalised or local
Cardiac edema: according to the gravitation (feet, legs, sacral region)
Renal edema (periorbital - generalized)
Hypoproteinaemic edema (generalized)
Deep vein thrombosis (on the effected extremity)
109.How should the Babinsky,s test be carried out and evaluated?
With a moderately sharp object such as a key, stroke the lateral aspect of the sole from the heel to the ball of the foot, curving medially across the ball. Use the lightest stimulus that will provoke a response. Dorsalflexion of the great toe with fanning of the other toes (Babinski response) indicates upper motor neuron disease.
110.What should be examined on the pupils?
Are they round, symmetric, sharp edged, central? Their consensual reaction to light and convergention
111.Give the hypnoid mental lesions
Somnolence, sopor, coma
112.Which are the most frequently tested reflexes on the upper extremities?
Radius, ulnar, biceps, triceps
113.Which are the most frequently tested reflexes on the lower extremities?
Patella, Achilles
114.Give the characteristics of meningeal agitation
Vomitus, nausea, fixed occiput, bradycardy, Brudzinki,s and Kernig,s positivity
115.Technic of investigation for Laséqué sign
Patient lying on his back feels pain, while elevating his legs, to 90 degrees
116.Which articulations are most frequently effected by gout?
The metacarpophalangeal articulation of the big toe
117.Give the functions of the cranial nerves 1-3
Sense of smell, vision, pupillary constriction, elevation of the upper eyelid and most of the extraocular movements respectively
118.Give the normal concentration of Se.Na.
137-145 mmol/l
119.Give the normal concentration of Se.Potassium
3.5-4.5 mmol/l
120.Give the normal concentration of Se. Glucose
3.6-6.0 mmol/l
121.Give the normal concentration of white blood cells
4.8-9.0 G/l
122.Give the normal concentration of Haemoglobin
12.0-150.0 g/l