Part 2 General Diagnosis

Front 1

The health history includes what?

Back 1

-Chief complaint
-Past health history
-Personal ans social history
-Review of system

Front 2

What is the reason the Pt is seeking care called?

Back 2

-Chief Complaint

Front 3

What does OPQRST stand for?

Back 3

-Onset
-Palliative/Provoking
-Quality of pain
-Radiating/Referral
-Site/Setting/Severity
-Timing

Front 4

What does past health history include?

Back 4

-"SAMPLE"
-Serious illnesses
-Previous injuries
-Hospitalizations
-Medications
-Allergies

Front 5

Family health history should include what?

Back 5

-Cardiovascular Disease
-Diabetes
-Stroke
-Cancer
-ect.

Front 6

Social and personal history should include what?

Back 6

-Marital status
-Occupation
-Diet
-Exercise
-Bowel and Urinary patterns
-Sleep
-Alcohol/tobacco/drug use
-Stress

Front 7

What is CAGE used for?

Back 7

- Alcoholism

Front 8

What does CAGE stand for?

Back 8

-C=Cutting down
-A=Annoyed by others criticisms
-G=Guilty Feeling
-E=Eye opener drink

Front 9

Height and weight should be measured on what?

Back 9

-A standing platform scale with height attachment

Front 10

What are the normal temperature values?

Back 10

-Oral: 98.6
-Rectal/Tympanic: 99.6
-Axilla: 97.6
-Ranges: 96-99.5F or 35-37.5C

Front 11

What are the normal pulse rates?

Back 11

-Adult: 60-100
-Newborn: 120-160
-Elderly: 70-80

Front 12

What are the normal respiratory rates?

Back 12

-Adult: 14-18
-Newborn: 44

Front 13

What are the normal blood pressure values?

Back 13

-90-120/60-80
-Values increase in the elderly

Front 14

What is an auscultatory gap?

Back 14

- it is the loss and reappearance of the pulsatile sound while listening with the stethoscope during cuff deflation.

Front 15

What is a Korotkoff sound?

Back 15

-Its a low pitch sound produced by turbulent blood flow in the arteries

Front 16

A difference of 10-15mm Hg between both arms means what?

Back 16

- The Pt may have an arterial occlusion such as an subclavian steal on the side on the decreased value

Front 17

What are some test for vertebrobasilar Artery insufficiency?

Back 17

-Barre-Lieou
-DeKleyn's
-Hallpike
-Hautants
-Underberg

Front 18

What is Barre-Lieou test?

Back 18

-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

Front 19

What is DeKleyns test?

Back 19

-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

Front 20

What is Hautants test?

Back 20

-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

Front 21

What is Hallpikes test?

Back 21

-An enhanced DeKleyns
-The doc does the movement

Front 22

What is underbergs test?

Back 22

-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.

Front 23

What does scaly eyebrows indicate?

Back 23

-Seborrhea

Front 24

The loss of the lateral 1/3 of your eyebrows indicates?

Back 24

-Myxedema
-Hypothyroidism(in kids its called creetinsim)

Front 25

Ptosis

Back 25

-Drooping od the eyelid
-Seen with Horner's syndrome, CN3 paralysis, and Myasthenia Gravis

Front 26

Exophthalmosis

Back 26

-Lid lag/failure to cover the eyeball
- seen with Graves Disease(bilateral) and Tumor(unilateral)

Front 27

Ectropion

Back 27

- the eye lid is turned outward
- seen in the elderly

Front 28

Entropion

Back 28

- the eye lid is turned inward
- seen in the elderly

Front 29

Periorbital Edema

Back 29

- Swelling around the eye
- Seen with allergies, myxedema, and nephrotic syndrome

Front 30

Blepharitis

Back 30

- inflammation of the eyes
- seen with seborrhea, staph infection and inflammatory processes

Front 31

Cataracts

Back 31

- opacities seen in the lens of the eye
- commonly seen with diabetes and in the elderly
-*absent red light reflex*

Front 32

Corneal Arcus

Back 32

- Grayish opaque ring around the cornea
- Early onset: under 50yr (Hypercholesterolemia)
- Late onset: elderly (normal)

Front 33

Pterygium

Back 33

- triangular thickening of the bulbar conjunctive that grows across the cornea

Front 34

Sclera

Back 34

-White: Normal
-Yellow: Jaundice
-Blue: Osteogenesis imperfecta

Front 35

Conjunctive

Back 35

-Pink: Normal
-Pale: Anemia
-Bright Red: Infection

Front 36

Hordoleum

Back 36

- An infection of the sebaceous glands causing a pimple or boil on the eyelid

Front 37

Chalazion

Back 37

- An infection of the meibomain gland causing a nodule which points inside the eye lid

Front 38

Pinquecula

Back 38

- A yellow triangular nodule in the bulbar conjunctive that is harmless and indicates aging

Front 39

Xanthelasma

Back 39

- Fatty plaques on the nasal surface of the eyelids
- normal: elderly
- hypercholesterolemia: non-elderly

Front 40

Argyll Robertson Pupil

Back 40

- 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

Front 41

Internal Ophthalmoplegia

Back 41

- dilated puple with ptosis and *lateral deviation*
- doesnt react to light or accommodate
-Multiple Sclerosis

Front 42

Mydriasis

Back 42

- Dilated and fixed pupils seen with anticholinergic drugs
- Stropin, mushrooms, or death

Front 43

Miosis

Back 43

- 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

Front 44

Anisocoria

Back 44

- Unequal pupil size

Front 45

Adie's Pupil

Back 45

-Sluggish pupillare reaction to light that is unilateral
-Caused by a parasympathetis lesion of CN3
-look for Arroyo sign

Front 46

Horner's Syndrome

Back 46

-Ptosis, miosis, and anhydrosis on the same side as an interruption to the cervical sympathetics

Front 47

Glaucoma

Back 47

-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

Front 48

Arroyo sign

Back 48

- sluggish pupillary reaction due to hypoadrenalism (addison's disease)

Front 49

Retinal Detachment

Back 49

- Painless sudden onset of blindness described as curtains closing over vision
-lighting flashes and floaters

Front 50

Macular Degeneration

Back 50

-M/C reason for blindness in the elderly
-central vision lost, macular drusen is and early sign(yellow deposit under the retina)

Front 51

Hypertensive Retinopathy

Back 51

-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*

Front 52

Diabetic Retinopathy

Back 52

-Affects the veins more than the arteries
-presents with microaneurysma, hard exudates and neovascularization

Front 53

Papilledema

Back 53

-AKA: Choked Disc
-swelling of the optic disc due to increased intracranial pressure
-seen with brain tumor or brain hemorrhage
-*NO VISUAL LOSS*

Front 54

Iritis

Back 54

- inflammation of the iris(the color part of the eye)
-seen with Ankylosing Sponylitis

Front 55

Emmetropia

Back 55

-Normal vision

Front 56

Myopia

Back 56

-Nearsighted

Front 57

Hyperopia

Back 57

Farsighted

Front 58

Presbyopia

Back 58

-Loss of lens elasticity due to again

Front 59

Direct light reflex

Back 59

-CN2 and CN3

Front 60

Consensual light reflex

Back 60

-CN3

Front 61

Accommodation

Back 61

-CN2 and CN3

Front 62

What do you use to test visual acuity?

Back 62

Snellen Chart

Front 63

Cardinal fields of gaze

Back 63

- CN 3, 4, 6

Front 64

Tinnitus

Back 64

- the presence of ringing in the ears

Front 65

Presbycussis

Back 65

-Sensorineural hearing loss that occurs in people as they age and they may be affected by genetic or acquired factors

Front 66

Acute Otitis Externa

Back 66

-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

Front 67

Acute Mastoiditis

Back 67

-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

Front 68

Purulent Otitis Media

Back 68

-a bacteria or viral infection in the middle ear
-the tympanic membrane presents with a red appearance, dilated blood vessels, and bulging

Front 69

Serous otitis Media

Back 69

-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

Front 70

Vertigo

Back 70

-An abnormal sensation of rotatory movement associated with difficulty in balance, gait and navigation of the environment

Front 71

Meniere's disease

Back 71

- 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)

Front 72

Benign Paroxysmal Positional Vertigo

Back 72

- A brief episode of vertigo brought on by change in head position
-DX by Dix-Hallpike's Maneuver
-treated by Eply's maneuver

Front 73

Acoustic Neuroma

Back 73

- Benign tumor of CN8 called a schwannoma
-hearing loss tinnitus vertigo and presents of the tumor on CT or MRI

Front 74

Eustachian Tube Block

Back 74

-Retraction of the tympanic membrane

Front 75

Viral Rhinitis

Back 75

- Nasal mucosa appears red and swollen with a clear runny nose

Front 76

Allergic Rhinitis

Back 76

- Nasal mucosa appears pale or blue and boggy

Front 77

Atrophic Rhinitis

Back 77

- Thinning of the nasal mucosa with sclerosis, crust formation and foul odor

Front 78

Polyps

Back 78

- Typically occurs as a consequence of chronic inflammation of the nasal mucosa

Front 79

Angular Stomatitis

Back 79

- 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

Front 80

Kaposi's Sarcoma

Back 80

-A multicentric neoplasm caused by the herpes virus type 8
-AIDS can be related
-Appears like a bruise on the hard palate

Front 81

Candidiasis

Back 81

-AKA Oral Thrush
- Thick white fungal patches that are easily scraped off

Front 82

Leukoplakia

Back 82

-Pre-cancerous lesion of white patches that are adherent to the surface and not easily removed

Front 83

Atrophic Glossitis

Back 83

-A vit B or iron deficiency
-Causes the tongue to have a smooth and glossy appearance

Front 84

Fissured Tongue

Back 84

- AKA Scrotal Tongue
- Deep furrows on the surface of the tongue that s consider a normal variant

Front 85

Gigantism

Back 85

- Excessive production of growth hormone (somatotrophin) prior to skeletal maturation

Front 86

Acromegaly

Back 86

-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

Front 87

Hyperthyroidism

Back 87

-M/C caused by Graves disease (autoimmune).
- TSH production is decreased and T3/T4 are increased

Front 88

Barrel Chest

Back 88

AP= lateral diameter
- seen in COPD and cystic fibrosis

Front 89

Pectus Excavatum

Back 89

-AKA funnel chest
-marked depression notes in the sternum

Front 90

Pectus carinatum

Back 90

-Pigeon Chest
-Forward protrusion of the sternum

Front 91

Tachypnea

Back 91

-rapid, shallow breathing

Front 92

Bradypnea

Back 92

-slow breathing

Front 93

Biot's Breathing

Back 93

-Characterized by groups of quick shallow inspirations followed by irregular periods of apnea

Front 94

Cheyne Stokes Respiration

Back 94

-Breathing pattern characterized by alternating periods of apnea and hyperpnea
-has a pattern and leads to respiratory acidosis

Front 95

Kussmaul's

Back 95

-Breathing is rapid and shallow but as metabolic acidosis worsens, breathing gradully becomes deep, slow, labored and gasping.
-air hunger breathing

Front 96

Hypothyroidism AKA

Back 96

Myxedema

Front 97

Hypothyroidism m/c in US

Back 97

Hashimoto's Thyroiditis

Front 98

Congenital Hypothyroid is called

Back 98

cretinism

Front 99

Hyperthyroid vs Hypothyroid: Weight/Appetite

Back 99

Hyper - weight loss with increased appetite
Hypo - weight gain with decreased appetite

Front 100

Hyperthyroid vs Hypothyroid: demeanor

Back 100

Hyper - irritable, nervous
Hypo - depression, fatigue, weakness

Front 101

Hyperthyroid vs Hypothyroid: Temp

Back 101

Hyper - intolerance to heat
Hypo - intolerance to cold

Front 102

Hyperthyroid vs Hypothyroid: Hair/skin

Back 102

Hyper - moist skin and fine hair
Hypo - coarse, dry hair and skin

Front 103

Hyperthyroid vs Hypothyroid: Eyes

Back 103

Hyper - Exopthalmos
Hypo - Periorbital Edema

Front 104

Hyperthyroid vs Hypothyroid: T3, T4, TSH

Back 104

Hyper: T3 (increased)
T4 (increased)
TSH (decreased)

Hypo: T3 (decreased)
T4 (decreased)
TSH (increased)

Front 105

Goiter found with

Back 105

Hyperthyroidism

Front 106

Loss of the lateral 1/3 of eyebrows found with

Back 106

Hypothyroidism