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205 Cards in this Set
- Front
- Back
This instrument is used with a pen light to visualize the lower and middle turbinates of the nose.
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Nasal Speculum
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This instrument is used to screen for auditory function and vibratory sensation as a part of the neurological exam.
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Tuning fork
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This instrument is used to test deep tendon reflexes.
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Percussion (Reflex) Hammer
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How do you open the blades of the nasal speculum?
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Squeeze the handles.
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What is the normal range of speech?
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300 - 3000 Hz
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This hammer has additional features, what is the name of the hammer and which feature should no longer be used?
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Neurological hammer & the Needle
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This instrument consist of a strong light source with a narrow beam.
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Transilluminator
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What does the transilluminator allow you to assess?
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The presence of fluid in sinuses, the presence of a mass or blood in the scrotum and abnormalities in the cranium of infants
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This instrumet has blades that are curved with a space between the closed blades. It also comes in metal or plastic.
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Vaginal speculum
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This instrument is used to determine the degree of joint flexion and extension.
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Goniometer
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This instrument contains a light source with a wave length of 360nm,
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Wood's Lamp
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What is the Wood's lamp used to identify and what color will it be?
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Fungi on skin lesions. It will turn a yellow-green color.
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This instrument is a skin surface microscope that uses epiluminescence microscopy (ELM).
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Dermatoscope
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What is a dermatoscope used for?
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To confirm a diagnosis or determine which skin lesion requires a biopsy or removal. It requires special training.
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This instrument is used to measure the thickness of subcutaneous tissue.
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Calipers
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This instrument is used to test for loss of protective sensations.
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Monofilament
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At what pressure does the monofilament bend?
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10 g of linear pressure
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A patient who can not feel the monofilament is at an increased risk of what?
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Injury
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After using the monofilament, what should you do to it?
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Wipe it with alcohol
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This is a state of acute confusion accompanied by a disorder of perception.
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Delirium
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This instrument is used with a pen light to visualize the lower and middle turbinates of the nose.
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Nasal Speculum
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This instrument is used to screen for auditory function and vibratory sensation as a part of the neurological exam.
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Tuning fork
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This instrument is used to test deep tendon reflexes.
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Percussion (Reflex) Hammer
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How do you open the blades of the nasal speculum?
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Squeeze the handles.
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What is the normal range of speech?
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300 - 3000 Hz
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This hammer has additional features, what is the name of the hammer and which feature should no longer be used?
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Neurological hammer & the Needle
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This instrument consist of a strong light source with a narrow beam.
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Transilluminator
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What does the transilluminator allow you to assess?
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The presence of fluid in sinuses, the presence of a mass or blood in the scrotum and abnormalities in the cranium of infants
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This instrumet has blades that are curved with a space between the closed blades. It also comes in metal or plastic.
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Vaginal speculum
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This instrument is used to determine the degree of joint flexion and extension.
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Goniometer
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What are the symptoms of delirium?
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Acute alterations in mental status, attention span, sleep patterns and affect.
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A person with delirium is unable to do what?
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Orient to place, time or circumstance, but maintains orientation to person.
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What is delirium associated with?
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Withdraw from large amounts drugs or alcohol, age-related, neurological, neoplastic, infections, trauma, toxins or stress.
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This is the brains response to withdraw of alcohol that was consumed in large quantities over time.
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Delirium Tremens
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What are the signs of Delirium Tremens?
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agitation, confusion, combativeness, seizures, hallucinations and illusions.
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What are the signs of alcohol withdraw?
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Elevated vital signs, irritability, anxiety, restlessness & anorexia.
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This is a clinical syndrome of failing memory and cognitive impairment, behavorial abnormalities & personality changes.
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Dementia
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What causes the symptoms of dementia?
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A chronic progressive deterioration of the brain.
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What are the causes of dementia?
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D- Drugs (Medications)
E- Emotional / Depression M- Metabolic / Endocrine E- Eyes, Ears, Environment N- Nutrition / Neurological T- Tumor / Trauma I- Infection A- Alcoholism, Anemia, Atherosclerosis |
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What are the clinical features of dementia?
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Memory impairment, disturbances in execuitive functions, and one or more of aphasia, apraxia or agnosia.
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What is the onset of delirium?
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Sudden
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What is the onset of dementia?
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Insidious, relentless, sporadic
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What is the duration of delirium?
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Hours to days - worse at night and when drug levels peak, sleep-wake cycle is distrubed
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What is the duration of dementia?
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Persistent - no change in time of day
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What types of impairment would a patient with delirium exhibit?
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Impairment of memory, attentiveness, consciousness & calculations
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What type of impairment would a patient with dementia exhibit?
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Impaired abstract thinking, judgement, memory, thought patterns, calculations, agnosia
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What type of personal activity would a patient with delirium exhibit?
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Fluctuates from increased to decreased, tremors, spastic movements
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What type of personal activity would a patient with dementia exhibit?
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Unchanged from normal behavior
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What type of speech characteristic would a patient with delirium exhibit?
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Rambling and irrelevant conversaion, illogical flow of ideas, incoherent
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What type of speech characteristic would a patient with dementia exhibit?
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Disordered, rambling, incoherent, struggles to find words
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What type of mood / affect would a patient with delirium exhibit?
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Rapid mood swings, fearful, suspicious
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What type of mood / affect would a patient with dementia exhibit?
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Depressed, apathetic, uninterested
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What type of delusions / hallucinations would a patient with delirium exhibit?
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Visual, auditory, tactile hallucinations & delusion
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What type of delusions / hallucinations would a patient with dementia exhibit?
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Only delusions, no hallucinations
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What type of triggers are associated with delirium?
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Physical condition, drug toxicity, brain injury, change in environment, vision or hearing problems
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What type of triggers are associated with dementia?
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Chronic alcoholism, vitamin B12 deficiency, Huntington chorea, vascular infarcts, HIV Encephalopathy, Alzheimers DZ
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Is delirium reversible?
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Yes
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Is dementia reversible?
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No
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This condition is a temporary alteration in mental status resulting from brain injury.
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Concussion
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What are common causes of concussions?
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Sports injuries, MVA's & falls
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What are the S/S of a concussion?
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Headache, dizziness, a dazed look, slurred speech, slow motor & verbal responses, emotional liability, restlessness, iritability, N/V, blurred vision, tinnitus, hypersensitivity to stimuli, amnesia, defects in coordination, cognition, memory and attention.
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If a patient has LOC, even for a few seconds, this indicates what?
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A more severe injury
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How long do symptoms of a concussion last?
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15 minutes to weeks
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This condition is the most common psychiatric disorder.
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Depression
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What causes depression?
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A lack of importaint neurotransmitters in the brain
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A patient with depression may complain of what?
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Memory loss, poor concentration, lack of motivation and indecisiveness.
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This condition is a persistently elevate, expansive or irritable mood lasting longer than a week.
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Mania
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What causes mania?
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A biochemical imbalance in the brain.
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What are symptoms of mania?
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Hyperactivity, overconfidence, exaggeration of ones abilities, delusion of grandure, decreased need for sleep, poor social judgement
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What might a person with mania exhibit?
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Racng thoughts or ideas, rapid fire speech, impaired social, occupational and interpersonal functions. Pt involves them selves in pleasureable activities but takes no pleasure in them.
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Panic attacks, panic disorders, agoraphobia, specific phobias, OCD, ATST and PTSD are all what?
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Anxiety disorders
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What are S/S of panic disorders?
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Palpitations, tachycardia, sweating, shaking, trembling, choking, chest pain, nausea, abd distress, dizziness, faintness, detached feelings, "going crazy" & paresthesia
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This condition is a severe, persistent psychotic disorder, that is a neuroanatomic and neurohormonal abnormality.
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Schizophrenia
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When does schizophrenia usually begin?
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Adolescent or early adult
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What does schizophrenia affect?
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A persons perceptions, thinking, language, emotions and social behavior.
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What are the subtypes of schizophrenia?
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Paranoid, disorganized, catatonia, mixed and residual (no active symptoms)
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This condition is manifested during the childs development by significant subaverage general intellectual functionsing, existing concurrently with deficits in adaptive behavior.
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Mental retardation
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What are S/S of mental retardation?
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Delayed developmental milestones, inability to discriminate between two or more stimuli, inpaired short term memory & lack of motivation
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This condition is a combination of behavorial problems that interfer with the childs ability to learn: includes inappropriate inattention and hyperactivity.
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Attention Deicit Hyperactivity Disorder (ADHD)
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What are some symptoms of ADHD?
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Inability to pay attention, hyperactivity, impulsivity, temper outburst, labile moods, poor self esteem
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When is the onset of ADHD?
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Before 7 years old
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What group is ADHD more common in?
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Boys
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This disorder is a pervasive developmental disorder that may result from left brain dysfunction.
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Autistic disorder
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Autism (Autistic Disorder) begins before what age?
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3 years
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In autism, the child had a deficit in what?
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At least 1 of these three areas:
Social interaction Language for social purposes Symbolic & Imaginative play |
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What type of speech may a child with autism exhibit?
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Language is delayed or not present - but Echolalia (Parrot speech) is common
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What are some behavorial traits common in autism?
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Lack of awareness of others, an aversion to touch or being held, odd or repetitive behaviors, preoccupation with parts of objects.
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This condition accounts for 60 - 70 % of dementia cases.
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Dementia of Alzheimer
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A person with dementia of alzheimer has an inability to do what?
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To learn new information, or recall previously learned information.
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What signs are present with a patient with dementia of alzheimers?
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Aphasia, araxia, agnosia or disturbance in executive funcion
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Who is at a greater risk of alzheimers?
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Women with a family history
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What does alzheimers lead to?
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Profound disintegration of personality and to eventually complete disorientation
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This condition has a rapid onset with deterioration in cognitive ability.
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Vascular Demenita (Multi-Infarct Dementia)
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What would a patient with Vascular Dementia exhibit?
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Impaired memory, an inability to learn new information or recall previously learned information, aphasia, apraxia, agnosia or disturbance in execuitive function.
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What are risks for Vascular Dementia?
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Long standing HTN, small strokes with out significant muscle strength loss
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An person with an apple shape body is at a greater risk of what?
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DM, hyperlipidemia, stroke, ischemic heart disease
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A baby with a larger birth weight than it's older sibilings (>10 lbs) is at a greater risk of what?
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Acute Lymphatic Leukemia
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A baby with a smaller birth weight that it's older sibilings (>6oz difference) think . . .
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An undisclosed congenital defect or intrauterine growth retardation
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This condition is characterized by gradual marked enlargement and enlongation of the bones of the face, jaw and extremities.
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Acromegaly
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This disorder is characterized by weight gain, muscle weakness, hyperpigmentation, oligomenorrhea or decreased testosterone and abnormally pigmented, fragile skin.
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Cushings syndrome
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What are the causes of cushings syndrome?
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Excessive cortisol production, long term steroid therapy, pituitary adenoma or adrenal malignancy.
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What causes hydrocephalus?
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When there is an imbalance between the production and absorption of CSF.
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What is "sun setting" sign?
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Paresis of the upward gaze - seen in an infant with hydrocephalus
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What are the manifstations of hydrocephalus?
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Increased intercranial pressure, head enlargement, widening ssutures & fontanels, lethargy, irritability, weakness and "setting sun" eyes
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This condition is characterized by an infant failing to grow at rates considered appropriate for the population.
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Failure to thrive.
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What are some causes of failure to thrive?
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Chronic disease that increases metabolic requirements, inability to feed due to neurological function, GE Reflux, Cleft palate, malabsorption or an emotionally deprived infant,
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This genetic disorder causes abnormalities in endochondral ossification.
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Achondroplasia
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What is Achondroplasia characterized by?
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Dwarfism with short, curved arms and legs, a long narrow trunk, midfacial hypoplasia and a prominent forehead.
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This disorder is caused by a hormone deficiency resulting in a child with short stature who appears young for his chronological age.
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Hypopituitary Dwarfism
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In hypopituitary dwarfism, what is the infants size at birth?
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Usually of normal size and weight at birth.
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This disorder is characterized by development with all secondary sexual characteristics and advancement in skeletal maturation.
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Precocious Puberty
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What are the ages of precocious puberty?
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Girls: Before age 8
Boys: Before age 9 |
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Precocious puberty may be associated with what?
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It usually is idiopathic, but may be associated wit central nervous system or gonadal neoplasm or to McCune-Albright Syndrome
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This disorder results from complete or partial absence of the second X chromosome and results ina phenotypic female.
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Turner Syndrome
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What are common clinical manifistations of Turners syndrome?
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Webbed neck, low posterior hairline, small mandible, epicanthal folds, high arched palate, inreased carrying angle of elboy, shield-shaped chest deformity with hypoplastic nipples, short stature, and congenital anomalies of heart and urinary tract
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When is Turners syndrome usually identified?
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During adolescence because of the absence of sexual development.
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What are the two types of obesity?
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Exogenous and Endogenous
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Describe exogenous obesity.
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Exogenous- there is an increase in the number of fat cells
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Describe endogenous obesity.
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Endogenous obesity- the fat cells are enlarged
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In exogenous obesity, what are the physical manifistations and who is affected?
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Primairly affects women and children. Most often found in the breast, buttocks and thighs, maintains muscle strength.
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In exogenous obesity, what is it linked to?
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Increased caloric intake.
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In endogenous obesity, what are the physical manifistations and who is affected?
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There is increased trunkal obesity. Usually affects men, but will affect women as well.
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A person with endogenous obesity is at a greater risk of what?
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Diabetes, heart disease, HTN & stroke
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A person with exogenous obesity is at a greater risk of what?
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Breast cancer
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This disorder is a psychological disorder where the patient has a distorted perception of their body shape.
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Anorexia Nervosa
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What population of people are commonly affected by anorexia nervosa?
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Adolescent & young women from mid to upper classes. Also men who participate in certain sports, are homosexual or have problems with addiction
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What are common signs of anorexia nervosa?
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Dry skin, lanugo hair, brittle nails, bloating, constipation, slow heart rate, orthostatic HypoTN, stunted growth, amenorrhea, intolerance to cold, carotene pigmentation, food preoccupation, depression or irritability, decreased libido and interrupted sleep.
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This disorder is characterized by binge eating.
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Bulemia
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If binge eating is followed by vomiting, what is this called?
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Bulimarexia.
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What population of people are commonly affected by bulemia?
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Men and women in late teens to early 20's. HX/O addiction.
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What usually follows a binge eating episode?
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Laxatives or diauretics - occasionally vomiting.
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What is hyperlipidemia?
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A cholesterol level >240g/100mL
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What constitutes a high risk patient and what is their LDL-C goal?
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Coronary Heart Disease, Hx/O MI, unstable angina, stale angina or coronary artery Sx.
Goal: <100mg/dL |
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What constitutes a moderate/ high risk patient and what is their LDL-C goal?
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2+ Risk factors, Cigarette smoking, HTN
Goal: <130mg/dL |
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What constitutes a moderate / low risk patient and what is their LDL-C goal?
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2+ Risk factors, Low HDL (<40 mg/dL)
Goal: <130mg/dL |
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What pain scale is best used for premature infants?
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Premature Infant Pain Profile (PIPP)
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What do you assess when using the PIPP?
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Cry, sleep patterns, facial expressions, feeding and suckling, overall tone and consolability.
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In regards to the PIPP scale, what describes an infant is hurting?
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A crying, hypertonic, sleepless baby who is unable to suck and unable to be consoled.
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What is the Individual Numeric Rating Scale (INRS) used for?
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Non-verbal children or other wise compromised patient of any age.
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This skin abnormality is flat or slightly elevated, circumscribed, painful lesion with a smooth hard surface.
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Corn
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A "soft" corn is caused by what and where is it usually located?
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Bony prominences - appearing as whitish thickness, usually between the fourth and fifth toe.
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A "hard" corn is caused by what and where is it usually located?
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Bony prominences where pressure is exerted (shoes) - usually on the interphalangeal joints of the toes
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This skin abnormality is a superficial area of hyperkeratosis.
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A callus
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Where do calluses usually occur?
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On the weight bearing areas of the feet and palmer surfaces on the hands.
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What differentates a callus from a corn?
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Corn- Painful, well circumscribed
Callus- Non-painful, not well demarcated |
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What is the most common inflammatory skin disorder?
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Eczematous dermatitis
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What are the stages of eczematous dermatitis?
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Acute-erythematous, pruritic, weeping vessicles
Sub Acute- erythema snd scaling, itching (possible) Chronic- think, lichenified, pruritic plaques |
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What is a furuncle?
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An acute localized staphylococcal infection.
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How does a furuncle usually begin?
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A small perifollicular abscess that spreads to the surrounding tissue
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What is folliculitis?
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Staphyloccal infection of the hair follicle and surrounding dermis.
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What size is the primary lesion in folliculitis?
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1 - 2 cm
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What is cellulitis?
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An acute, diffuse streptococcal or staphyloccal infection of the skin and surrounding tissue
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How does the skin look in cellulitis.
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Red, hot, tender & indurated. Lymphangic streaks and regional lymphadenopathy are possible.
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What is Tinea?
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A group of noncandidal fungal infections that involve the statum corneum, nails or hair.
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What is tinea located on hairy parts of the body called?
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Tinea corporis
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What is tinea located on the groin and inner thigh called?
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Tinea cruris
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What is tinea located on the scalp called?
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Tinea capitis
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What is tinea located on the feet called?
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Tinea pedis
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What is tinea on the nails called?
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Tinea unguium
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What is pityriasis rosea?
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A self-limiting inflammation of unknown cause.
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What is the onset of pityriasis rosea?
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Sudden with occurence of a primary oval or round plaque with fine, superficial scaling.
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This skin condition manifest in a christmas tree like pattern.
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Pityriasis rosea
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This is a chronic and recurrent disease of keratin synthesis.
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Psoriasis
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What does psoriasis look like?
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Well circumscribed, dry, silvery, scaling papules and plaques- commonly located on the back, buttocks, scalp and extensor surfaces of the extremities.
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What characterized rosacea?
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Telangiectasia, erythema, papules and pustules that occur particulary in the central are of the face.
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What is the most common skin reaction to a drug?
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Drug eruptions- discrete or confluent maculopapoules on the trunk, face, extremities, falms or soles of the feet.
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A viral infection usually following a single dermatone is...
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Herpes zoster
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What is the most common form of skin cancer?
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Basal cell carcinoma
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Where does basal cell carcinoma usually occur?
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On exposed parts of the body- face, ears, neck, scalp, shoulders & back
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This skin cancer commonly occurs on the back of hands, lower lip & ear.
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Squamous cell carcinoma
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What are the ABCD's of melanoma?
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A- Asymmetory
B- Boarders C- Color D- Diameter |
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A malignant tumor of the endothelium and epithelial layer of the skin is what?
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Karposi Sarcoma
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A sudden, rapid, patchy loss of hair usually from the scalp or face is what?
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Alopecia areata
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Lesions of Kaposi Sarcoma are characterized by...
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Soft, vascular, bluish-purple and painless. More common due to the increase in HIV infections.
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This type of alopecia results from skin disease of the scalp that causes scaring and destruction of hair follicules.
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Scaring alopecia
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What questions would you ask when preforming a mini-mental exam?
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Orientation to time (What is the date?) Registration of time (Repeat these words) Naming (What is this?) Reading (Please read this.)
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A patient who gives inappropriate responses to questions, has a decreased attention span and memory is what?
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Confused
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A patient who is drowsy, falls asleep quickly, but once aroused- responds appropriately is what?
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Lethargic
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A patient who is confused with disordered perceptions and decreased attention span, marked anxiety with motor and sensory excitement, and inappropriate reactions to stimuli is what?
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Suffering from delirium
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A patient who is arousable for short pperiods to visual, verbal or painful stimuli, has simple motor or moaning responses to stimuli or slow responses is suffering from?
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Stupor
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A patient who is neither awake or aware, decerbrate posturing to painful stimuli is in what state?
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A coma
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A patient with Broca's aphasia would have what type of word comprehension?
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Fair to good
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A patient with Broca's aphasia would have what type of spontanous speech?
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Cannot express self using language; few words; laborious effort; primairly uses nouns and verbs (eg. eat pie, get mail)
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A patient with Broca's aphasia would have what type of reading comprehension?
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Intact
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A patient with Broca's aphasia would have what type of writing?
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Impaired
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What are some causes of spider angiomas?
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Liver disease, Vitamin B deficiency, idiopathic
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A red-purple, nonblanching discoloration greater thant 0.5 cm in diameter is what?
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A purpura
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What are some causes of purpura?
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Intravascular defects, infection
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A bluish spider, linear or irregularly shaped, does not blanch is what?
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A Venous Star
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What are some causes of a venous star?
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Increased pressure in superficial veins
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A red-purple nonblanchable discoloration less than 0.5 cm is what?
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Petechiae
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What are some causes of petechiae?
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Infection, intravascular defects
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A fine, irregular red line is what?
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A telangiectasia
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What are some causes of telangiectasia?
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Dilation of capillaries
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A red-purple nonblanchable discoloration of variable size is what?
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Ecchymoses
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What are some causes of ecchymoses?
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Vascular wall destruction, trauma, vasculitis
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A red lesion with irregular macular patches is what?
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A capilary hemangioma
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What are some causes of capillary hemangiomas?
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Dilation of dermal capillaries
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A rotten apple odor is indicative of what?
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Clostridium gas gangrene
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A Mousy odor is indicitative of what?
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Proteus infection
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A Grape like odor is indicative of what?
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Pseudomonas infection (especially burns)
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A pungent body odor is indicative of what?
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Schizophrenia
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A stale beer odor is indicative of what?
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Tuberculous lymphandenitis (scrofula)
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A putrid odor is indicative of what?
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Anaerobic infection, scurvy
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A Feculent odor is indicative of what?
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Intestinal obstruction, peritonitis
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