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171 Cards in this Set
- Front
- Back
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For blood pressure, width of bladder cuff should be about ____% of upper arm circumference.
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40
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For blood pressure, length of bladder cuff should be about _____% of upper arm circumference.
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80
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What are the values associated with the following blood pressures?
Normal Prehypertension Stage 1 Hypertension Stage 2 Hypertension If Diabetes or Renal Disease |
Normal <120/80
Prehypertension 120/80-139/89 Hypertension Stage 1 140/90-159/99 Hypertension Stage 2 >160/100 If Diabetes or Renal Disease <130/80 |
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Normal heart rate range:
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50-90 bpm
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Things to report on when assessing respiration rate:
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Rate
Rhythm Depth Effort of breathing |
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Normal body temperature
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98.6 F (37 C)
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Oral temperature low in early morning hours:
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96.4 F (35.8 C)
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Oral temperature high in late afternoon/evening:
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99.1 F (37.3 C)
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Rectal temperatures are _______ than oral temperatures by an average of ______.
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Rectal is higher than oral by .7-.9 F (.4-.5 C)
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Axillary temperatures are _______ than oral temperature by an average of _______.
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Axillary is lower than oral by 1 degree
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Tympanic temperatures are ______ than oral temperature by an average of _______.
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Tympanic is higher than oral by 1.4 F (.8 C)
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The normal respiratory rate is _______.
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14-20 per minute in adults (up to 44 in infants)
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Melanoma Risk Factors
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History of previous melanoma
Age > 50 Regular dermatologist absent Mole changing Male gender |
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ABCDE for detecting melanoma
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Asymmetry
Irregular Borders Color variation Diameter >6mm Evolution/Elevation |
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Definition of Mobility and Turgor
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Mobility - How easily fold of skin lifts up
Turgor - How quickly it returns to its place |
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What characteristics of the skin should you note on inspection?
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Color
Moisture Temperature Texture Mobility and Turgor |
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What features of a lesion should you note on inspection?
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Anatomic location and distribution
Type skin lesion (macule, papule, vesicle, etc.) Color Pattern and shapes |
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Patterns of Skin Lesions:
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-Linear
-Clustered -Annular (Circular, Oval, Ring) -Arciform (in an arc) -Geographic -Serpiginous (worm-like) |
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Slightly but uniform pigmented macule or patch with irregular border is called ______
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Cafe-Au-Lait Spot
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Hypo- or hyper-pigmented, slightly scaly macules on the trunk, neck, and upper arms is _____
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Tinea Versicolor
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Depigmented macules appearing on the face, hands, feet, extensor surfaces that coaleasce into extensive areas lacking melanin is called ______
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Vitiligo
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A yellow palm without a yellow scelra is probably _____
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Carotenemia
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Violaceous patches over the eyelids is part of this disease _____
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Heliotrope
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Reddish oval ringworm-like papules or plaques with a herald lesion on the back is seen in ________
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Pityriasis Rosea
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Silvery scaly papules or plaques, mainly on the extensor surfaces (knees, elbows) is seen in _______
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Psoriasis
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Tan, flat, scaly plaques is seen in __________
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Tinea Versicolor
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A small, flat nonpalpable lesion with a change in skin color that is less than 1.0 cm in diameter is known as a __________
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Macule
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A flat nonpalpable lesion with a change in skin color that is 1.0 cm or greater in diameter is known as a __________
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Patch
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An elevated, palpable lesion that is less than 1.0 cm in diameter is known as a __________
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Papule
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An elevated, palpable lesion that is 1.0 cm or greater in diameter is known as a __________
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Plaque
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An elevated, palpable lesion that is knot-like, deep, and firm, and larger than .5 cm is known as a __________
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Nodule
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A nodule that is filled with expressible material (liquid or semisolid) is known as a __________
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Cyst
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An elevated, palpable lesion that is somewhat irregular, relatively transient, and edematous is known as a __________
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Wheal
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An elevated, palpable lesion with a cavity filled with serous fluid, that is less than 1.0 cm in diameter is known as a ________
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Vesicle
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An elevated, palpable lesion with a cavity filled with serous fluid, that is 1.0 cm or greater in diameter is known as a ________
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Bulla
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An elevated, palpable lesion with a cavity filled with pus (yellow proteinaceous fluid with neutrophils) is known as a ________
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Pustule
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A minute, slightly raised tunnel in the epidermis, looking like a gray line, and often found on the finger webs is know as a __________
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Burrow
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A thin flake of dead exfoliated epidermis is known as a _____
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Scale
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The dried residue of skin exudates is known as a _____
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Crust
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Palpable thickening of the epidermis and roughening of the skin with increases visibility of normal skin furrows is known as a _____
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Lichenification
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Increased connective tissue that arises from injury or disease is known as a _____
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Scar
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Hypertrophic scarring that extends beyond the borders of initiating injury is known as a _____
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Keloid
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Non-scarring loss of superficial epidermis that is moist but does not bleed is known as a _____
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Erosion
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Linear or punctate erosions caused by scratching is known as a _____
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Excoriation
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A linear crack in the skin, often resulting from excessive dryness is known as a _____
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Fissure
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A deep loss of epidermis and dermis that may bleed and scar is known as a _____
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Ulcer
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What is the most common cutaneous disorder in the US?
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Acne vulgaris
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Comedones, occasional paplues and pustules, and sometimes cysts are seen in what disease?
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Acne vulgaris
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A fiery red vascular lesion less than 2 cm in diameter with a central body surrounded by radiating legs is known as a ___________
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Spider angioma
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A bluish vascular lesion most commonly in the legs is known as a _______
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Spider vein
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A bright or ruby red, round vascular lesion 1-3 mm in size is know as a __________
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Cherry angioma
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A deep red or purple lesion less than 3 mm in diameter and fades away over time is known as a _____
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Petechia
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A deep red or purple lesion greater than 3 mm in diameter and fades away over time is known as a _____
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Purpura
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A purple to blue lesion that fades to green, yellow, and brown over time is known as a ________
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Echymosis
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Superficial hyperkeratotic papules that are pink, tan, or gray could be ________
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Actinic Keratosis
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Whitish-yellowish to brown raised papules or plaques that feel slightly greasy and velvety with a "stuck on" appearance could be _______
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Seborrheic Keratosis
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An initial pearly red macule or papule the develops a depressed center and firm, elevated border could be ______
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Basal cell carcinoma
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Crusted hyperkeratotic lesions with a rough surface or flat reddish patches with an inflamed ulcerated appearance could be ____
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Squamous cell carcinoma
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Clearly demarcated round or oval patches of hair loss with no visible scaling or inflammation is known as ____
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Alopecia Areata
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Hair loss from pulling, plucking, or twisting hair is known as __________
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Trichotillomania
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Round scaling patches of hair loss is known as ________
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Tinea Capitis (Ringworm)
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A superficial infection of the proximal and later nail folds, which are red, swollen, and tender, may reflect ______
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Paronychia
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A bulbous swelling of the soft tissue at the nail base with loss of normal angle between the nail and proximal nail fold is ___________
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Clubbing
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A painless separation of the whitened opaque nail plate from the pinker transulescent nail bed is known as _____
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Onycholysis
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A nail plate that turns white with ground-glass appearance with a distal band of red-brown and obliteration of the lunlula is known as ______
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Terry's Nails
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What are the fundamentals of Skilled Interviewing (according to Bates)?
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Active listening
Empathic responses Guided questioning Nonverbal communication Validation Reassurance Partnering Summarization Transitions Empowering the patient |
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What is the sequence of the interview?
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Preparation
Greet the patient and establish rapport Establish an agenda Invite the patient's story Explore the patient's perspective Identify and respond to emotional cues Expand and clarify the patient's story Generate and test diagnostic hypotheses Share the treatment plan Close the interview Take time for self-reflection |
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What does PEARLS stand for, with regard to the interview process?
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Partnership
Empathy Apology Respect Legitimization Support |
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What does FIFE stand for, with regard to the interview process?
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Feelings
Ideas effect on Function Expectations |
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How should you deal with a silent patient?
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Be attentive
Be respectful Convery encouragement to continue Watch closely for nonverbal cues Think about depression or dementia Think about methodology (too many questions? did you do something wrong?) |
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How should you deal with a confusing patient?
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Focus on context of symptom
Emphasize patient's perspective Guide the interview into psychosocial assessment |
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How should you deal with a patient with altered capacity?
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Determine whether patient has decision making capacity
Consider a second history source (loved one, healthcare proxy) |
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How should you deal with a talkative patient?
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Give patient free reign for first 5-10 minutes
Listen closely Focus on what seems most important to patient Do not show impatience Interrupt only when necessary Summarize to validate |
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How should you deal with a crying patient?
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Respond with empathy
Make a supportive remark |
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How should you deal with an angry or disruptive patient?
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Accept the angry feelings
Validate their feelings without agreeing with their reasons Alert security before approaching pt if overly disruptive Stay calm and keep posture relaxed Avoid being confrontational |
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How should you deal with the patient with a language barrier?
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Find trained interpreter (not family members)
Make questions clear, short, simple Speak directly to patient (not interpreter) |
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How should you deal with the patient with low literacy?
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Be sensitive
Do not confuse degree of literacy with level of intelligence Explore reasons that reading is difficult |
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How should you deal with a patient with hearing loss?
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Ask patients preferred method of communication (written, interpreter)
Eliminate background noise Speak at normal volume and rate without trailing off Avoid covering mouth or looking down Always write out patient plans and instructions |
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How should you deal with a patient with impaired vision?
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Shake hands
Explain who you are and why you are there Orient patient to surroundings |
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How should you deal with a patient with limited intelligence?
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Show interest in patient first but turn to family for history
Engage in simple coversation Avoid talking down |
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How should you deal with a patient with personal problems?
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Don't provide answer
Ask about pros and cons of thoughts and supports |
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How should you deal with a seductive patient?
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Accept sexual feelings and bring them to conscious level
Keep relationship within professional bounds Calmly but firmly make it clear your relationship is professional Find chaperone |
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The carotid upstroke is delayed in what condition?
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Aortic stenosis
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Listening with the ______ of your stethoscope a the apex while the patient is in the left lateral decubitus position will accentuate __________
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Listen with the bell.
Accentuates S3, S4, Mitral stenosis |
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Listening with the ______ of your stethoscope while the patient is sitting leaning forward and holding their breath after expiration will accentuate ________
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Listen with the diaphragm.
Accentuates aortic regurgitation. |
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How should you describe a murmur?
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Timing
Shape Radiation Quality Pitch Location Intensity on 1-6 scale |
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What are the 6 grades of murmurs?
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1 = very faint, heard only after listener is "tuned in"
2 = quiet, but heard immediately after placing stethoscope on chest 3 = moderately loud 4 = loud with palpable thrill 5 = very loud with palpable thrill (may be heard with stethoscope partly off chest) 6 = very loud with palpable thrill (may be heard with stethoscope entirely off chest) |
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What is the only systolic murmur that increases with valsalva maneuver/?
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Hypertrophic cardiomyopathy
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Pulsus alternans indicates ________
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Left ventricular failure
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Fixed splitting of S2 occurs in __________
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Atrial Septal Defect
Right ventricular Failure |
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Paradoxical splitting of S2 occurs in ________
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Left bundle branch block
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A medium-high pitch pansystolic murmur heard best at the apex that does not become louder with inspiration is ________
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Mitral regurgitation
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A medium pitch pansystolic murmur heard best at the LLSB that becomes louder with inspiration is _________
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Tricuspid regurgitation
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A high pitch pansystolic murmur heard best at the 3rd-5th left interspaces that is very loud and often accompanied by a thrill is _________
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VSD
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A soft-medium pitch mid-systolic murmur heard best at the 2nd-4th left interspaces that decreases when sitting is ___________
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Innocent murmur
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A medium pitch crescendo-decrescendo systolic murmur heard best at the 2nd right interspace but radiating over the entire left side is _______
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Aortic stenosis
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A medium pitch systolic murmur heard best at the 3rd and 4th left interspaces but radiating to the apex is ______
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Hypertrophic cardiomyopathy
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A medium pitch crescendo-decrescendo systolic murmur heard best at the 2nd-3rd left interspace radiating to the shoulder and neck is ______
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Pulmonic stenosis
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A high pitch decrescendo diastolic murmur heard best at the 2nd-4th left interspaces is _________
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Aortic Regurgitation
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A low pitch diastolic murmur heard best at the apex with an opening snap and loud S1 is ___________
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Mitral stenosis
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A continuous low pitch murmur without a silent interval heard best above the medial third of the clavicles is __________
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Venous Hum
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A high pitch murmur with three short components, 1 in systole and 2 in diastole, heard best in the left 3rd interspace is ___________
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Pericardial friction rub
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A continuous medium pitch murmur with a silent interval in late diastole, heard best at the left 2nd interspace is ____________
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Patent Ductus Arteriosus
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A high pitch systolic murmur with a mid-systolic click heard best at the apex is __________
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Mitral valve prolapse
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An S3 in an adult over 40 years old may indicate _______
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Decrease myocardial contractility
Heart failure Volume overload (mitral or tricuspid regurgitation) |
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A left-sided S4 may indicate __________
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Hypertensive heart disease
Myocardial ischemia Aortic stenosis Cardiomyopathy |
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A right-sided S4 may indicate _________
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Pulmonary hypertension
Pulmonary stenosis |
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A PMI greater than 2.5 cm indicates __________
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LVH
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A tearing or ripping chest pain radiating to the neck or back is _________
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Aortic dissection
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Bounding pulse is seen in which murmur?
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Aortic regurgitation
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S1 is diminished in __________
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first degree heart block
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S2 is diminished in ___________
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aortic stenosis
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Standing and valsalva will decrease the intensity of which murmur?
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Aortic stenosis
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A blood pressure difference of more than 10 mmHg between the arms suggests ________
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Aortic dissection
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Palpation of an irregularly irregular pulse rhythm suggests ________
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Atrial fibrillation
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Hypertension in the arms and low pulse pressure in the legs suggests _________
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Aortic coarctation
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Slow breathing is known as _______
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Bradypnea
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Sighing respiration should alert you to the possibility of __________
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Hyperventilation syndrome
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Rapid shallow breathing is known as ________
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Tachypnea
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Periods of deep breathing alternating with periods of apnea is known as ________
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Cheyne-Stokes Breathing
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Expiration is prolonged in ___________
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Obstructive breathing
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Unpredictable, irregular breathing is known as _______
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Biot's Breathing
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Rough, dry, cool skin and sparse, coarse hair is seen in _________
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Hypothyroidism
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Warm, velvety skin and fine, silky hair is seen in _________
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Hyperthyroidism
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Spider angiomas are indicative of what conditions?
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-Liver disease
-Pregnancy -Vit B deficiency |
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Spider veins are indicative of what condition?
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Varicose veins
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Terry's nails are indicative of what conditions?
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Liver disease
Heart failure Diabetes |
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Pitting of the nails is usually associated with what condition?
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Psoriasis
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Thunderclap headaches are indicative of what condition?
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Subarachnoid Hemorrhage
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Difficulty seeing close is known as _______
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Hyperopia
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Flashing lights and new visual floaters indicates ________
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Retinal Detachment
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Excessive facial hair is known as _________ and occurs in women with __________
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Known as Hirsutism
Women with polycystic ovary syndrome |
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Inability to see part of a temporal field is known as _________
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Hemianopsia
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Impaired near vision in older people is known as ________
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Presbyopia
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Constriction of the pupil is known as _______
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Miosis
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Dilation of the pupil is known as ________
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Mydriasis
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Proptosis and poor convergence of the eyes is seen in which disorder?
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Hyperthyroidism
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An enlarged cup seen during the opthalmic exam is indicative of what condition?
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Open-angle glaucoma
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Higher frequency hearing loss in older adults is known as ________
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Presbycusis
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Enlargement of the thyroid gland to twice its original size is known as _____
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Goiter
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Vertigo lasting hours to days and occurring with sensorineural hearing loss is most likely ________
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Meniere's Disease
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Vertigo lasting seconds and occuring without any hearing loss is most likely _______
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Benign Positional Paroxysmal Vertigo
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Vertigo lasting days with hearing impairment in one hear is most likely ________
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Acoustic Neuroma
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Slightly raised, yellowish, well-circumscribed plaques that appear along the nasal portion of the eyes is _______
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Xanthelasma
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Inflammation of the nasolacrimal sac is _______
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Dacryocystitis
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A corneal arcus is suggestive of ________
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Hyperlipoproteinemia
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A kayser-fleischer ring is seen in which disorder?
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Wilson's disease
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Anisocoria and ptosis along with differing colored irises is seen in which disorder?
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Horner syndrome
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Small, irregular pupils that accommodate but do not react to light indicate ___________
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Argyll Robertson pupils
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Strabismus in which the eye turns nasally is _______
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Esotropia
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Strabismus in which the eye turns laterally is ________
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Exotropia
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A common cause of deep retinal hemorrhages is _______
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Diabetes
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Microaneurysms in the retina are a hallmark of ________
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Diabetic retinopathy
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Tophi are seen in patients with ___________
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Gout
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Increased fremitus occurs in what condition?
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Pneumonia (increased consolidation)
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A pressing or squeezing chest pain that radiates to the shoulder, arms, and jaw is _______
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Angina pectoris or Myocardial Infarction
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A sharp knifelike chest pain radiating to the shoulder that is relieved when sitting forward is _____
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Pericarditis
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A severe ripping chest pain radiating to the neck and back is _________
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Dissecting Aortic Aneurysm
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A sharp knifelike chest pain that worsens with inspiration or coughing is _________
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Pleuritis
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Pink frothy sputum coming on at night and during exertion indicates _____
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Pulmonary edema (possibly from LVF or Mitral stenosis)
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Rusty colored sputum is indicative of _______
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Strep pneumonia
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__________ of the arm is a common finding after axillary node dissection and radiation therapy.
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Lymphedema
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Intermittent claudication with marked pallor of the foot upon elevation suggests________
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Arterial insufficiency
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Brawny changes in the skin with pitting edema and an ulceration indicates______
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Chronic Venous Insufficiency
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Thick skin with non-pitting edema in the lower leg suggests ________
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Lymphedema
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What is the BMI range for: Underweight? |
<18.5 |
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What is the BMI range for: Normal? |
18.5-24.9 |
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What is the BMI range for: Overweight? |
25-29.9 |
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What is the BMI range for: Obesity Class I? |
30-34.9 |
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What is the BMI range for:Obesity Class II? |
35-39.9 |
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What is the BMI range for: Extreme Obesity Class III? |
>40 |
