Patient Assessment Test 2 Set 2

Front 1

Normal Mole
a)shape
b)color
c)surface
d)size
e)number

Back 1

a)round w/ clearly defined border
b)tan/brown (look same from one person to another)
c)flat to raised
d)less than 5mm (pencil eraser size)
e)10-40 all over body

Front 2

Dysplastic Mole
a)shape
b)color
c)surface
d)size
e)number

Back 2

a)irregular/fading borders
b)tan/brown and red/pink (look different from one another)
c)smooth, scaly, pebbly
d)larger than 5mm to 10mm
e)100 or more

Front 3

Mongolian Spots
a)desc
b)most often in who?
c)resolution
d)other (2)

Back 3

a1)bluish/black/gray spots
a2)on back, butt, shoulders, legs

b)babies w/ dark skin

c)disapperas in preschool years

d1)often mistaken for bruises
d2)congenital disorder

Front 4

Milia in Infants
a)desc (2)
b)cause (2)

Back 4

a1)small, white, discrete papules on face
a2)found in first 2-3months of life

b)sebaceous glands fxn in an immature fashion
b2)making them easily plugged

Front 5

Sebaceous Hyperplasia in Newborn?
a)desc (2)
b)cause
c)location
d)resolution

Back 5

a1)baby acne
a2)tiny yellow macules and papules in newborn

b1)result of androgen stimulation from mother
c)on forehead, cheek, nose, chin

d)gone after within 1-2months of age

Front 6

Striae
a)desc (4)
b)cause (3)

Back 6

a1)stretch marks
a2)pink/silver lines on epidermis
a3)benign
a4)may indicate systemic disease

b1)weakening of elastic tissue
b2)associated w/ pregnancy, wt gain, rapid growth
b3)corticosteroids

Front 7

Linea Nigra
a)desc
b)cause
c)resolution

Back 7

a1)hyperpigmentation of linea nigra
a2)darkened band down center of abdomen

b)pregnancy

c)resolves spontaneously

Front 8

Cherry Angioma (6desc)

Back 8

1)bright red
2)violaceous
3)domed lesions
4)on trunk
5)appear around 30yo and incr w/ age
6)no consequence just cosmetic

Front 9

Seborrheic Keratosis (4)

Back 9

1)most common benign epithelial tumors
2)hereditary that appear @ age 30 and incr over the years
3)starts as macule and becomes more pigmented and increases in size
4)takes on appearance of being "stuck on"

Front 10

Cutaneous Horn

Back 10

1)small hard projections of epidermis

Front 11

Solar Lentigo (3)

Back 11

1)brown macules
2)localized proliferation of melanocytes
3)due to chronic exposure to sunlight

Front 12

Contact Dermatitis (2)

Back 12

1)acute inflammatory rxns to substances that come into contact w/ skin
2)hypersensitivity rxn

Front 13

Cellulitis (2desc and 1cause)

Back 13

1)acute, spreading infexn of dermal and SQ layers
2)red, hot, tender area

1)caused by group A beta-hemolytic streptococci or staph aureus

Front 14

Tinea (1desc and 4ex)

Back 14

1)fungal infexn of skin
2)get from contact with animals
3)contaminated soil
4)warm humid environment
5)others

Front 15

Psoriasis (4desc)

Back 15

1)hereditary
2)chronic scaling papules and plaques
3)sharply marginated lesions
4)silvery while scale

Front 16

Drug Eruptions?

Back 16

allergic rxn to meds that result in dermatologic manifestations

Front 17

Herpes Zoster (SHINGLES) (3desc)

Back 17

1)unilateral pain
2)vesicular/bullous eruption limited to a dermatome
3)1/3 as contagious as varicella

Front 18

Herpes Simplex (3)

Back 18

1)grouped vesicles
2)erythematous base on skin
3)very painful

Front 19

Basal Cell Carcinoma desc (3)

Back 19

a1)most common type of skin cancer
a2)malignant tumor that is locally invasive
a3)not very metastatic

Front 20

Squamos Cell Carcinoma (5desc)

Back 20

1)malignant tumor
2)on epithelium and mucous membranes
3)arises from exogenous carcinogens (mostly UV)
4)lots on upper lip/nose/ear and left hand/ear due to driving
5)erosive ("rat eaten area")

Front 21

Malignant Melanoma (4)

Back 21

1)worst skin cancer
2)develops from melanocytes and metastasizes
3)look for sores that do NOT heal and a persistant lump/swelling
4)has different dimensions (flat/raised)

Front 22

Impetigo (2desc and 2causes)

Back 22

1)superficial infection of epidermis
2)CRUSTED erosions

1)caused by staph aureaus
2)caused by strep pyogens

Front 23

Solar Keratosis (Actinic Keratosis) (4)

Back 23

1)precanceous lesions
2)dry, rough scaly lesions
3)occurs on sun exposed skin
4)can develop into squamos cell

Front 24

Cafe au Lait Spots (4)

Back 24

1)flat, evenly pigmented spots
2)brown or black
3)larger than 5mm in diameter
4)present @ birth or shortly thereafter

Front 25

Port-Wine stain (3)

Back 25

1)vascular malformation of dermal blood vessels
2)present at birth and never disappears completely
3)congenital defect

Front 26

Folliculitis (3desc and 2treatment)

Back 26

1)infexn of upper portion of hair follicle
2)caused by staph aureus
3)shaving/hair extraction is cause

1)treat by oral/topical Abx
2)or don't shave

Front 27

Furuncle (3desc and 1ex)

Back 27

1)deep seated
2)red, tender nodule
3)very painful

1)caused by staph aureus
2)no penicillin b/c resistant

Front 28

Carbuncle (3desc and tx)

Back 28

1)deeper infection than furnucle
2)comprised of interconnecting abscesses arising in several hair follicles
3)caused by staph aureus

1)no penicillin b/c resistant

Front 29

Corn (3)

Back 29

1)PAINFUL lesion w/ smooth hard surface
2)caused by pressure of bony prominence against softer tissue
3)make sure pt is wearing right size shoe

Front 30

Callus (3)

Back 30

1)superficial area of hyperkeratosis
2)occurs on WEIGHT-BEARING areas of feet/palms
3)NOT PAINFUL/TENDER

Front 31

Warts (4desc and 1tx)

Back 31

1)verucca vulgaris
2)spread from skin-to-skin contact
3)cause by minor trauma w/ breaks in epidermis
4)caused by HPV

1)tx is do nothing and warts will disappear in a year

Front 32

Pityriasis Rosea**** (4)

Back 32

1)starts with SINGLE HERALD patch lesion on trunk
2)resolves in 6wks w/o therapy
3)misdx a lot and cause is unknown
4)looks like ringworm

Front 33

Eczema (3desc and 1tx)

Back 33

1)chronic inflammation of the epidermis/dermis due to skin allergies
2)often in ppl w/ a personal/family history of hay fever, asthma, allergy
3)ECZEMA IS THE ITCH THAT RASHES

1)tx is cortisone

Front 34

Scabies/Skin Mites (4)

Back 34

1)intraepidermal burrow is the pathognomonic sign of scabies
2)usually other members of family will have it
3)pustular lesions of palms, webs of fingers
4)crusted and scaling or blistering rashes

Front 35

Male pattern pubic hair

Female pattern pubic hair

Back 35

Male is triangle

Female is upside down triangle

Front 36

Scarring Alopecia
a)results from...
b)tx

Back 36

a)skin diseases (tinea) that cause destruction of hair follicles

b)needs oral antifungal

Front 37

Traction Alopecia cause

Back 37

due to prolonged tension of hair (braids etc)

Front 38

Hirsutism (2)

Back 38

1)male pattern hair growth on face, body and pubic area in women
2)incr adipose tissue (obesity) can cause this

Front 39

Headlice
a)how transmitted (3)

Back 39

a)direct head-to-head contact and sharing of grooming items (lice canNOT jump/hop/fly)
b)eggs are grayish-white-brown
c)eggs resistant to pesticides and need to be removed w/ nit-comb

Front 40

Black/green nail color causes (3)

Back 40

1)pseudomonas
2)melanoma
3)injury (can also cause splinter hemmorrhages)

Front 41

Yellow nails caused by... (3)

Back 41

1)psoriasis
2)fungal infexn
3)respiratory diseases

Front 42

White nails caused by... (2)

Back 42

2)cuticle manipulation
3)picking @ nails as nervous habit

Front 43

Separation of nail bed causes what? (3)

Back 43

1)white/yellow/green tinge
2)on nonadherent portion of nail
3)fix by putting hole in nail

Front 44

____ indicate poor grooming of nails and can...

Back 44

1)jaggen, broken, bitten edges

can predispose that pt to infexn

Front 45

Examine ____ and ____ for ingrown nails/infexn and ____ will be present

Back 45

proximal and lateral nail folds

pain/swelling

Front 46

____ nails may indicate clubbing

Back 46

boddy (not firm)

Front 47

Paronychia (2)

Back 47

1)inflammation or infexn of the nail
2)often has purulent drainage (pus)

Front 48

Tinea Unguium (3desc and 1tx)

Back 48

1)fungal infexn of nail
2)nail turns yellow/white
3)FLAKES OFF (or crumbles)

1)treat for 3months (w/ Lamisil) then will clear up after a year

Front 49

Subungual Hematoma (3desc and 1tx)

Back 49

1)bruise/trauma to nail plate causing bleeding under nail
2)causes separation of nail from nail bed
3)will remain until nail grows out

1)drill hole to release pressure

Front 50

Habit-tic Deformity? (2)

Back 50

1)caused by biting/picking at the nail
2)results in horizontal grooving

Front 51

Onycholysis (1desc and 6causes)

Back 51

1)loosening of nail plate w/ separation of the nail from nail plate

1)minor trauma
2)psoriasis
3)candida
4)pseudomonas
5)allergic contact dermatitis
6)hyperthyroidism

Front 52

Crepitus is...

Back 52

popping

Front 53

a)immovable joints
b)slightly movable joints
c)movable joints (synovial joints)

Back 53

a)fixed as a result of fibrous tissue (skull)

b)fibrocartilage joins the articulating bones (pubic)

c)bone structures come in contact w/ each other

Front 54

a)Hinge joint
b)Pivot joint
c)Condyloid joint

Back 54

a)permits movement in one axis (elbow)
b)permits rotation in one axis along the shaft of bone (proximal radioulnar joint--think cerebellum test)
c)permits movement in 2 axes (wrist)

Front 55

a)Saddle joint
b)Ball-and-Socket joint
c)Plane joint

Back 55

a)articular joints are saddle shaped (thumb)
b)motion is possible in many axes (hip/shoulders)
c)articular surfaces are flat and one bone rides over the other (patellofemoral joint)

Front 56

Passive ROM?

Back 56

motion elicited by the examiner's moving the pt's body

Front 57

Active ROM?
and how is joint motion measured?

Back 57

motion the pt performs as a result of moving the musculature

in degrees of a circle

Front 58

FIRST Six basic types of joint motion

Back 58

1)flexion: motion away from 0 position
2)extension: motion toward the zero position

3)dorsiflexion: movement in direction of dorsal surface
4)plantar flexion: movement in direction of plantar surface

5)adduction: movement toward midline (add to body)
6)abduction: movement away from midline

Front 59

SECOND Six basic types of joint motion

Back 59

1)inversion: turning plantar surface of foot inward
2)eversion: turning of the plantar surface of foot outward

3)internal rotation: turning of anterior surface of a limb inward
4)external rotation: turning of the anterior surface of a limb outward

5)pronation: rotation so that the palmar surface of the hand is directed downward
6)supination: rotation so the palmar surface of hand is directed upward (hold bowl of soup)

Front 60

Grading Muscle Strength (6)

Back 60

0) no evidence of mvmnt
1) trace of mvmnt
2) full ROM, but not against gravity
3) full ROM against gravity but not against resistance
4) full ROM against gravity and some resistance, but weak
5) full ROM against gravity and full resistance

Front 61

When assessing should strength and "shrugging the shoulders against resistance" hurts then...

Back 61

damage to CN11

Front 62

Location of DIP/PIP/MIP

Back 62

DIP is in finger and furthest from palm

PIP is in finger and in middle of finger

MIP is in finger and close to palm

Front 63

Anatomically correct for hands =

Back 63

palms towards ceiling if laying down

Front 64

Adduction/Abduction of ankle measured by....

Back 64

goinometer

Front 65

Most prominent vertabrat in back (2)

Back 65

C7
T1

Front 66

Lordosis? (3)

Back 66

NORMAL bending in neck/lower back

Excess Lordosis seen in:
1)obese
2)pregnant

Front 67

Kyphosis (2)

Back 67

NORMAL upper back that bends over

Excess Kyphosis seen in:
aging adults

Front 68

TMJ syndrome
a)symptoms (4)
b)causes (4)
c)tx (4)

Back 68

a1)painful jaw mvmnt w/ dull pain and tenderness in TMJ area
a2)HA on waking
a3)tenderness of jaw muscles
a4)jaws get stuck or lock

b1)lost or crooked teeth
b2)overbite
b3)teeth that fit together poorly (malocclusion)
b4)degenerative arthritis

c1)NSAIDs
c2)heat/cold
c3)decr movement/mouth guard
c4)stress reduction

Front 69

Trigger Finger
a)cause
b)symptoms (2)

Back 69

a)painless nodule in flexor tendon in palm, near head of metacarpal

b1)finger extends w/ palpable/audible snap as nodule pops into tendon sheath
b2)gets stuck going back up

Front 70

Dupuytren's Contracture
a)what is it/cause (2)
b)symptoms (2)

Back 70

a1)flexion contractures in the ring, 5th and 3rd fingers
a2)caused by thickening of the palmar fascia

b1)thickened plaque overlying the flexor tendon of ring finger @ distal palmar crease
b2)thickened fibrotic cord develops b/w palm and finger

Front 71

Tenosynovitis
a)what is it
b)what causes it
c)symptoms (2)

Back 71

a)inflammation of tendon sheath
b)puncture wounds/infexn

c1)tenderness/swelling develops ALONG COURSE OF TENDON SHEATH
c2)digits are held in slight flexion and attempts to extend it are very painful

Front 72

De Quervain's Tenosynovitis
a)big thing about it
b)cause
c)symptoms (2)
d)positive test for it
e)tx

Back 72

a)OVERUSE INDEX
b)tenosynovitis due to narrowness of tendon sheath

c1)WEAKNESS OF GRIP ESPECIALLY W/ GALLON OF MILK
c2)pain at base of thumb

d)have pt flex thumb and close fingers over it, move hand into ulnar deviation (if pain then + test)

e)radial splint

Front 73

Carpal Tunnel Syndrome
a)sx (3)
b)caused by...
c)onset related to...
d)tx (3)

Back 73

a1)pain/numb on ventral surface of hand (especially @ night)
a2)problems w/ thumb, 1st, 3rd finger
a3)weak abduction

b)MEDIAN NERVE COMPRESSION
c)repitive motion

d1)NSAIDs
d2)immobilization
d3)surgery

Front 74

Thenar Atrophy (2)

Back 74

1)muscular atrophy localized to the thenar eminence
2)hypothenar atrophy suggests an ulnar nerve disorder

Front 75

Tinel's Sign*****
a)assess's ____
b)useful in dx of...
b)positive test is...

Back 75

a)median nerve
b)carpal tunnel
c)pt will complain of electric sensation/pain into thumb, index, middle, ring fingers WHEN percussing skin over median nerve

Front 76

Phalen's Manuver*****
a)assess's _____
b)useful in dx of...
c)positive test is....

Back 76

a)median nerve
b)carpal tunnel
c)FLEX WRIST: pain/tingle to thumb, index, middle, ring fingers within 60s of wrist flexion

Front 77

Epicondylitis (lateral)
a)other names (2)
b)sx (3)
c)cause

Back 77

a1)tennis elbow
a2)lateral epicondylitis

b1)follows repititive extension of wrist or protonation/supination of forearm
b2)pain over lateral epicondyle
b3)pain incr w/ extension of wrist against resistance

c)OVERUSE

Front 78

Epicondylitis (medial)
a)other names (3)
b)sx
c)cause

Back 78

a)pitchers, golfers, little league elbow
b1)follows repitive wrist flexion (like throwing)
b2)pain over medial epicondyle
b3)pain incr w/ flexion of wrist

c)OVERUSE

Front 79

Tennis elbow tx (4)

Back 79

1)NSAIDs
2)RICE (rest, ice, compression, elevation)
3)strap
4)stop aggrevating factors

Front 80

Tendinitis
a)other name
b)cause/involves (4)

Back 80

a)rotator cuff (impingent syndrome)
b1)repeated shoulder motion (throw/swim)
b2)MOST COMMONLY INVOLVES SUPRASPINATUS TENDON
b3)pt complains of sharp pain/weakness when lifting arm overhead
b4)have pt hold hand/arms out and have em press against your hands as your press down (WILL GET PAIN)

Front 81

Supraspinatus (Rotator Cuff) Strain
a)active ROM is...
b)cause/sx (2)
c)drop arm test?

Back 81

a)45-120degrees
b1)due to falls/overuse causing partial or complete tear
b2)will see shrugging of should in complete tear

c)pt unable to oppose even gentle downward force on arm held @ 90degrees

Front 82

Bursitis
a)what is it
b)cause
c)sx

Back 82

a)inflammation of A bursa (bursa sac that sits b/w 2 bones/joints)
b)often caused by overuse of joint
c)pain w/ movement/rotation and inability to perform certain movements

Front 83

Shoulder Bursitis (3)

Back 83

1)subacromial bursitis
2)abduction of should compresses bursa
3)tenderness just below tip of acromion and pain w/ abduction and rotation

Front 84

Olecranon bursitis (2)

Back 84

1)swelling over olecranon
2)ELBOW STICKS OUT***

Front 85

Trochanteric bursitis

Infrapatellar bursitis

Prepatellar bursitis

Back 85

1)swelling of trochanteric bursa on greater trochanter of femur

1)swelling of tibial tubercle

1)swelling over patella FROM EXCES KNEELING ("housemaid's knee")

Front 86

Trendelenburg sign (4)******

Back 86

1)detects weakness of hip abductor muscles
2)pt balances on "good leg" and the pelvis on opposite side elevates
3)pt balances on "bad leg"--a + test will have the pelvis/butt fatt on opposite side
4)if iliac crest drops on side of lifted leg, the hip abductor muscles on wt-bearing side are weak

Front 87

Ballottement

Back 87

1)used to determine presence of fluid or effusion in knee

Front 88

McMurray test (3)*****

Back 88

1)used to detect a torn medial or lateral meniscus (cartilage in knee)
2)flex knee completely, rotate foot to lateral position and keeping foot in that position, extend knee to 90degrees
3)flex knee again and repeat procedure w/ foot in medial position

Front 89

Anterior Drawer Test
a)test for...
b)how to do (4)

Back 89

a)ACL tear
b1)w/ pt supine (laying down), hips flexed and knees flexed to 90degrees and feet flat on table
b2)cup your hands around knee w/ your thumbs on the medial and lateral joint line and fingers on medial/lateral insertions of the hamstrings
b3)draw the tibia forward and see if it slides forward from under femur
b4)compare both knees and a movement greater than 5mm is +

Front 90

Posterior drawer test
a)test for...
b)how to do (3)

Back 90

a)PCL tear
b1)position pt and place your hands in position desc in anterior drawer test
b2)push the tibia posteriorly and observe the degree of backward movement in femur
b3)movement of knee greater than 5mm is +

Front 91

VALGUS stress test (5)

Back 91

1)test stability of MCL
2)move thigh about 30degrees laterally to side of table
3)place one hand against the lateral knee to stabilize femur and other around medial ankle
4)push medially against knee and pull laterally at angle to open knee joint on medial side
5)LAXITY indicates injury to MCL

Front 92

VARUS stress test (4)

Back 92

1)test stability of LCL
2)place one hand against the medial surface of knee and the other around the lateral ankle
3)push laterally against the knee and pull medially at the ankle to open knee joint on lateral side
4)LAXITY indicates injury to MCL

Front 93

Ligament connects

Back 93

bone to bone

Front 94

Tendon connects

Back 94

muscle to bone

Front 95

Baker's Cyst (2)

Back 95

1)distension of gastrocnemius (calf) bursa
2)located in popliteal fossa (behind knee)

Front 96

Genu Varum
a)other name
b)other
c)tx

Back 96

a)BOWLEGS
b)many infants have for 18mo then knock knees up to 3yo and corrects by 9-10yo
c)most cases it requires NO TX

Front 97

Genu Valgum?

Back 97

knock-knees

Front 98

Tendinitis (achilles especially)
a)sx (2)
b)tx (2)

Back 98

a1)tenderness/thickness of tendon above calcaneus
a2)causes pain w/ walking

b1)NSAIDs/steroids
b2)immobilizaiton

Front 99

Strain?
a)3things
b)tx (2)

Back 99

a1)TRAUMA TO MUSCLE
a2)tear to muscle
a3)most common in: hamstring, quadriceps, calf

b1)ice/rest
b2)muscle strengthening

Front 100

Sprain (ankle)
a)3things
b)sx (2)

Back 100

a1)TRAUMA TO JOINT/LIGAMENT
a2)most commonly involves: anterior talofibular ligament, calcaneofibular, posterior talofibular
a3)usually an INVERSION INJURY

b1)swelling/heat/bruise
b2)limited fxn

Front 101

Ankle Sprain tx (4)

Back 101

1)RICE
2)brace
3)ROM exercises
4)avoid stress on it