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95 Cards in this Set

  • Front
  • Back
The health history includes what?
-Chief complaint
-Past health history
-Personal ans social history
-Review of system
What is the reason the Pt is seeking care called?
-Chief Complaint
What does OPQRST stand for?
-Onset
-Palliative/Provoking
-Quality of pain
-Radiating/Referral
-Site/Setting/Severity
-Timing
What does past health history include?
-"SAMPLE"
-Serious illnesses
-Previous injuries
-Hospitalizations
-Medications
-Allergies
Family health history should include what?
-Cardiovascular Disease
-Diabetes
-Stroke
-Cancer
-ect.
Social and personal history should include what?
-Marital status
-Occupation
-Diet
-Exercise
-Bowel and Urinary patterns
-Sleep
-Alcohol/tobacco/drug use
-Stress
What is CAGE used for?
- Alcoholism
What does CAGE stand for?
-C=Cutting down
-A=Annoyed by others criticisms
-G=Guilty Feeling
-E=Eye opener drink
Height and weight should be measured on what?
-A standing platform scale with height attachment
What are the normal temperature values?
-Oral: 98.6
-Rectal/Tympanic: 99.6
-Axilla: 97.6
-Ranges: 96-99.5F or 35-37.5C
What are the normal pulse rates?
-Adult: 60-100
-Newborn: 120-160
-Elderly: 70-80
What are the normal respiratory rates?
-Adult: 14-18
-Newborn: 44
What are the normal blood pressure values?
-90-120/60-80
-Values increase in the elderly
What is an auscultatory gap?
- it is the loss and reappearance of the pulsatile sound while listening with the stethoscope during cuff deflation.
What is a Korotkoff sound?
-Its a low pitch sound produced by turbulent blood flow in the arteries
A difference of 10-15mm Hg between both arms means what?
- The Pt may have an arterial occlusion such as an subclavian steal on the side on the decreased value
What are some test for vertebrobasilar Artery insufficiency?
-Barre-Lieou
-DeKleyn's
-Hallpike
-Hautants
-Underberg
What is Barre-Lieou test?
-Pt is seated, the examiner instructs the pt to rotate the head maximally from side to side. starting out slow and ending at pt tolerance
What is DeKleyns test?
-Pt is supine and the examiner instructs the pt to extend and rotate their head off the table and then cont to rotate side to side for 15-45 sec
What is Hautants test?
-Pt is seated with their arms stright out in front of them with their palms supinated. then the pt closes their eyes and rotates and hyperextends the neck to one side and then the other side
What is Hallpikes test?
-An enhanced DeKleyns
-The doc does the movement
What is underbergs test?
-Pt stands with eyes open, hands at their side and feet close together. then the pt closes eyes, extends their arms an supinate their palms while extending and rotates the head to one side. then the pt can start marching in this position.
What does scaly eyebrows indicate?
-Seborrhea
The loss of the lateral 1/3 of your eyebrows indicates?
-Myxedema
-Hypothyroidism(in kids its called creetinsim)
Ptosis
-Drooping od the eyelid
-Seen with Horner's syndrome, CN3 paralysis, and Myasthenia Gravis
Exophthalmosis
-Lid lag/failure to cover the eyeball
- seen with Graves Disease(bilateral) and Tumor(unilateral)
Ectropion
- the eye lid is turned outward
- seen in the elderly
Entropion
- the eye lid is turned inward
- seen in the elderly
Periorbital Edema
- Swelling around the eye
- Seen with allergies, myxedema, and nephrotic syndrome
Blepharitis
- inflammation of the eyes
- seen with seborrhea, staph infection and inflammatory processes
Cataracts
- opacities seen in the lens of the eye
- commonly seen with diabetes and in the elderly
-*absent red light reflex*
Corneal Arcus
- Grayish opaque ring around the cornea
- Early onset: under 50yr (Hypercholesterolemia)
- Late onset: elderly (normal)
Pterygium
- triangular thickening of the bulbar conjunctive that grows across the cornea
Sclera
-White: Normal
-Yellow: Jaundice
-Blue: Osteogenesis imperfecta
Conjunctive
-Pink: Normal
-Pale: Anemia
-Bright Red: Infection
Hordoleum
- An infection of the sebaceous glands causing a pimple or boil on the eyelid
Chalazion
- An infection of the meibomain gland causing a nodule which points inside the eye lid
Pinquecula
- A yellow triangular nodule in the bulbar conjunctive that is harmless and indicates aging
Xanthelasma
- Fatty plaques on the nasal surface of the eyelids
- normal: elderly
- hypercholesterolemia: non-elderly
Argyll Robertson Pupil
- Bilaterally small and irregular pupils that accommodate but do not react to light
-seen with syphilis
-Diff Dx: Adies pupil- sluggish pupillary reaction to light unilateral
Internal Ophthalmoplegia
- dilated puple with ptosis and *lateral deviation*
- doesnt react to light or accommodate
-Multiple Sclerosis
Mydriasis
- Dilated and fixed pupils seen with anticholinergic drugs
- Stropin, mushrooms, or death
Miosis
- fixed and constricted pupils the react to light and accommodate
- seen with sever brain damage, pilocarpine medications and narcotic use
-Also with Cluster HA, Horners, and Barre-laeou
Anisocoria
- Unequal pupil size
Adie's Pupil
-Sluggish pupillare reaction to light that is unilateral
-Caused by a parasympathetis lesion of CN3
-look for Arroyo sign
Horner's Syndrome
-Ptosis, miosis, and anhydrosis on the same side as an interruption to the cervical sympathetics
Glaucoma
-Increase intraocular pressure causeing cupping of the optic disc( cup to disc ratio is >1:2)
-Pt will notice blurring of their vision in the peripheral fields as well as rings around lights
-Tangental lighting well produce crescent sign
Arroyo sign
- sluggish pupillary reaction due to hypoadrenalism (addison's disease)
Retinal Detachment
- Painless sudden onset of blindness described as curtains closing over vision
-lighting flashes and floaters
Macular Degeneration
-M/C reason for blindness in the elderly
-central vision lost, macular drusen is and early sign(yellow deposit under the retina)
Hypertensive Retinopathy
-Damage to the retinal vessels/background will show:
-*Copper wire deformity, silver wire deformity, A-V nicking, Flame and splinter hemorrhages and Cotton wool soft exudates*
Diabetic Retinopathy
-Affects the veins more than the arteries
-presents with microaneurysma, hard exudates and neovascularization
Papilledema
-AKA: Choked Disc
-swelling of the optic disc due to increased intracranial pressure
-seen with brain tumor or brain hemorrhage
-*NO VISUAL LOSS*
Iritis
- inflammation of the iris(the color part of the eye)
-seen with Ankylosing Sponylitis
Emmetropia
-Normal vision
Myopia
-Nearsighted
Hyperopia
Farsighted
Presbyopia
-Loss of lens elasticity due to again
Direct light reflex
-CN2 and CN3
Consensual light reflex
-CN3
Accommodation
-CN2 and CN3
What do you use to test visual acuity?
Snellen Chart
Cardinal fields of gaze
- CN 3, 4, 6
Tinnitus
- the presence of ringing in the ears
Presbycussis
-Sensorineural hearing loss that occurs in people as they age and they may be affected by genetic or acquired factors
Acute Otitis Externa
-an infection of the outer ear
-often associated with swimming and is frequently referred to as swimmers ear
- the pt will experience inflammation and pain of the outer ear. tugging on the pinna will be painful
Acute Mastoiditis
-Middle ear infection
-bacterial infection of the mastoid process
-same symptoms as acute otitis media with inflammation and pop over the mastoid
-hearing loss is associated
Purulent Otitis Media
-a bacteria or viral infection in the middle ear
-the tympanic membrane presents with a red appearance, dilated blood vessels, and bulging
Serous otitis Media
-An effusion in the middle ear resulting from incomplete resolution of acute otitis media or obstruction of the eustachian tube
-usually chronic and presents with bubbly amber fluid
Vertigo
-An abnormal sensation of rotatory movement associated with difficulty in balance, gait and navigation of the environment
Meniere's disease
- A disorder characterized by recurrent prostrating vertigo, sensory hearing loss, tinnitus and a feeling of fullness in the ear
-If they add facial weakness think acoustic neuroma(CN7)
Benign Paroxysmal Positional Vertigo
- A brief episode of vertigo brought on by change in head position
-DX by Dix-Hallpike's Maneuver
-treated by Eply's maneuver
Acoustic Neuroma
- Benign tumor of CN8 called a schwannoma
-hearing loss tinnitus vertigo and presents of the tumor on CT or MRI
Eustachian Tube Block
-Retraction of the tympanic membrane
Viral Rhinitis
- Nasal mucosa appears red and swollen with a clear runny nose
Allergic Rhinitis
- Nasal mucosa appears pale or blue and boggy
Atrophic Rhinitis
- Thinning of the nasal mucosa with sclerosis, crust formation and foul odor
Polyps
- Typically occurs as a consequence of chronic inflammation of the nasal mucosa
Angular Stomatitis
- Red sores at the corner of the mouth that are referred to as angular cheilitis/stomatitis
-can be caused by a Vit B2 (riboflavin) deficiency
Kaposi's Sarcoma
-A multicentric neoplasm caused by the herpes virus type 8
-AIDS can be related
-Appears like a bruise on the hard palate
Candidiasis
-AKA Oral Thrush
- Thick white fungal patches that are easily scraped off
Leukoplakia
-Pre-cancerous lesion of white patches that are adherent to the surface and not easily removed
Atrophic Glossitis
-A vit B or iron deficiency
-Causes the tongue to have a smooth and glossy appearance
Fissured Tongue
- AKA Scrotal Tongue
- Deep furrows on the surface of the tongue that s consider a normal variant
Gigantism
- Excessive production of growth hormone (somatotrophin) prior to skeletal maturation
Acromegaly
-Excessive production of growth hormone (somatotrophin) beginning in middle age.
-results in abnormal growth in the hands, feet and facial bones
-If they only say increased skull size think Paget's
Hyperthyroidism
-M/C caused by Graves disease (autoimmune).
- TSH production is decreased and T3/T4 are increased
Barrel Chest
AP= lateral diameter
- seen in COPD and cystic fibrosis
Pectus Excavatum
-AKA funnel chest
-marked depression notes in the sternum
Pectus carinatum
-Pigeon Chest
-Forward protrusion of the sternum
Tachypnea
-rapid, shallow breathing
Bradypnea
-slow breathing
Biot's Breathing
-Characterized by groups of quick shallow inspirations followed by irregular periods of apnea
Cheyne Stokes Respiration
-Breathing pattern characterized by alternating periods of apnea and hyperpnea
-has a pattern and leads to respiratory acidosis
Kussmaul's
-Breathing is rapid and shallow but as metabolic acidosis worsens, breathing gradully becomes deep, slow, labored and gasping.
-air hunger breathing