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161 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Which of the following are considered "diseases of civilization"? MACA
a. Alcoholism b. Cancer c. Heart Disease d. Hypertension e. Obesity |
b, c, d
Cancer, Heart Dz, Hypertension (arthritis too) |
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What are the 3 ways that many chronic degenerative diseases are prevented?
a. Diet b. Meditation c. Improved Sleep d. Lifestyle modification e. Exercise |
a, d, e
Diet, Exercise, lifestyle modification |
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What percentage of diagnoses are made from the Health History?
a. 0% b. 25% c. 58% d. 82% e. 94% |
d. 82%
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What percentage of clinical diagnosis comes from the lab & x-ray findings?
a. 0% b. 9% c. 19% d. 25% e. 47% |
b. 9%
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What percentage of clinical diagnosis comes from the physical examination?
a. 0% b. 9% c. 19% d. 25% e. 47% |
b. 9%
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What is the most important technique you can use to gain information during the interview?
a. Use non-medical terms b. Have a positive attitude c. Listen to the patient fully d. Lead the conversation with questions e. Reaffirm things the patient says |
c. Listen to the patient fully (don't interrupt)
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True/False? You create a differential diagnosis list before the exam but after the health history.
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True
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True/False? You create a differential diagnosis list after the exam but before the health history.
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False, before
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Which of the following steps follow the general sequence of the examination? MACA
a. Do the most invasive step first b. Don't tell the patient something "might hurt" c. Do the most stressful procedure last d. Examine the uninjured side first e. Explain in detail what you are testing for |
c, d (and one more step)
Begin with the LEAST invasive procedure Leave most stressful procedure last Examine the uninjured side first |
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A mother telling you what she saw her child do during an accident would be an _________ (objective/subjective) finding.
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objective (done by an observer)
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What are the 4 main techniques used during a physical examination?
a. Auscultation b. Palpation c. Reflex Checking d. Inspection e. Percussion |
d, b, e, a (in order)
Inspection, Palpation, Percussion, Auscultation FOLLOW UP: Which of the 4 often yields the most information? |
Inspection yields the most information.
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What part of the hands are best for feeling temperature?
a. dorsal side of the hand b. palmar side of hand c. fifth metacarpal d. fingertips e. none of the above |
a. dorsal side of the hand
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What part of the hands are best for feeling vibration?
a. dorsal side of the hand b. palmar side of hand c. fifth metacarpal d. fingertips e. none of the above |
c. fifth metacarpal
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What part of the hands are best for palpating size, shape and tenderness of body structures?
a. dorsal side of the hand b. palmar side of hand c. fifth metacarpal d. fingertips e. none of the above |
d. fingertips
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Doing indirect percussion with your hands, you place your indominant middle finger on the skin and strike that finger with the _______ finger of your dominant hand
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middle (or third)
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During percussion, the finger you place on the patient is called the
a. target b. center c. localized area d. plexor e. pleximeter |
e. pleximeter
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During percussion, the finger you strike your indominant finger with is called the
a. target b. center c. localized area d. plexor e. pleximeter |
d. plexor
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If I percuss the scapula, what type of sound should I hear?
a. resonance b. hyper-resonance c. dull d. flat e. tympany |
d. flat
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If upon percussion, I hear a dull sound, what am I likely overlying?
a. normal tissue b. lungs with possible emphysema c. solid organ d. bone e. bowel gas |
c. solid organ
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Patient presents complaining of stomach pain and upon light percussion, you hear a tympany sound. What is this indicative of?
a. emphysema b. ruptured appendix c. diarrhea d. diverticulitis e. bowel gas |
e. bowel gas
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If you hear hyper-resonance when percussing the lungs, you may be hearing:
a. emphysema b. Brown lung c. pleural effusion d. ruptured lung e. none of the above |
a. emphysema
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I am using the bell on my stethoscope. What sounds should I be looking for?
a. high pitched b. low pitched |
b. low pitched
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I am suspicious of a heart murmur in my patient. What part of the stethoscope should I be using on the patient?
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the bell
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I am listening to the patient inhale and exhale, listening for problems with the lungs. What part of the stethoscope is pressed upon the patient?
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the diaphragm
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When do you complete the MOST INVASIVE part of the physical examination?
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last!
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Name the 7 factors you must document to determine a chief complaint.
Hint: LSTQQMA |
L- Location - "Where is it?"
S - Setting - "What factors contribute to the complaint?" T - Timing - "When did it start? How long does it last?" Q - Quality - "What is it like?" Q - Quantity - "How bad is it?" M - Modifying factors - "What makes it better/worse?" A - Associated symptoms |
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What does the "P" stand for in the OPQRST abbreviation? (hint: 5 p's)
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Provocation, Palliation, Persistance, Progression, Prior
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Name the "R's" in the OPQRST abbreviation. (Hint: 3 of them)
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Radiation, Restriction, Region
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Name the 4 "S's" in the OPQRST abbreviation.
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Site, severity, sequelae, symptoms
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Name the whole OPQRST abbreviation:
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Onset - Provocation, Palliation, Persistance, Progression, Prior - Quality, Quantity - Radiation, Restriction, Region - Site, Severity, Sequelae, Symptoms - Timing
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What type of arthritis has pain that typically is worst in the morning and gets better with activity?
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Rheumatoid Arthritis
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What type of arthritis is called "wear and tear" arthritis?
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osteoarthritis
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Match the quality of pain patterns
1. Vascular pain 2. Fracture 3. Muscle 4. Nerve 5. Bone a. sharp and shooting b. deep, boring pain c. throbbing d. sharp, severe, no improvement w/rest e. cramping, dull, achy |
vascular - throbbing
fracture - sharp, severe, no improvement w/rest muscle - cramping, dull, achy nerve - sharp and shooting bone - deep and boring pain |
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Which of the following is NOT considered a "pertinent negative" history item?
Are you experiencing any... a. numbness b. fixations c. bowel/bladder issues d. tingling e. weakness |
b. fixations
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What 3 items should be obtained in a patient's past health history (ex. past surgeries)?
a. What or why? b. Location of occurrence? c. Method of injury? d. When? e. Outcome? |
a. What or why?
d. When? e. Outcome? |
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Name at least 5 family health history conditions you should document.
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a) Heart disease
b) High BP c) Stroke d) Diabetes e) Arthritis f) Cancer g) Tuberculosis h) Blood disorders |
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What are the 4 questions you should ask someone who abuses alcohol? (Hint: CAGE)
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a) C-Have you ever felt the need to Cut down on your drinking?
b) A-Have you ever felt Annoyed by criticism of your drinking? c) G-have you ever felt Guilty about your drinking? d) E-Have you ever felt the need for a morning Eye-opener drink? |
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Which of the following is NOT an element of the general survey portion of the physical exam?
a. behavior b. blood pressure c. body structure d. mobility e. physical appearance |
b. blood pressure
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A hypothyroid tendency may be observed in a patient with (increased/decreased) body temperature.
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decreased
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True/False? A patient with an increased temperature likely indicates inflammation or infection.
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True
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True/False? A patient with an decreased temperature likely indicates inflammation or infection.
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False - increased
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What type of thermometer has a lesser chance of cross contamination between patients?
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tympanic
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What 3 variables are documented when recording a pulse? (Hint: RAR)
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Rate
Amplitude Rhythm |
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What is the most important factor that leads to BP measurement errors?
a. arm not level with heart b. back not supported c. wrapping the cuff too loosely d. deflating the cuff too slow/fast e. incorrect arm cuff size |
e. incorrect cuff size
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What syndrome might be indicated by recording a significant difference in BP between two arms?
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subclavian steal syndrome (aka arterial occlusion)
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Taking a blood pressure, the loss and reappearance of the pulse's sound during cuff deflation is called the ___________ ___.
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auscultatory gap
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During what phase(s) of BP can you hear the auscultatory gap?
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Phase II and III
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During what phase(s) of BP can you hear the systolic Korotkoff sound?
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Phase I
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During what phase(s) of BP can you hear the diastolic Korotkoff sound?
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Phase IV and V
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The ___________ ___ is caused by the vascular stiffness that results from ________ and is seen primarily in the elderly?
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auscultatory gap - atherosclerosis
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Describe what pulsus paradoxus is
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Due to DECREASED intrathoracic pressure, SYSTOLIC decreases during inspiration and increases during expiration
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What is the significance of a pulsus paradoxus?
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if the systolic fall during inspiration is greater than 10 mm Hg, could indicate constrictive pericarditis or emphysema
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What is the definition of orthostatic hypotension?
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Systolic drops more than 20mmHg when moving from supine to standing
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What is different from a normal BP reading and Raglund's test?
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Patient stands during Raglund's.
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Patient presents with a BP of 128/89 in both arms. What is the follow-up procedure?
a. none b. recheck in 1 year c. recheck in 2 years d. confirm within 2 years e. refer immediately |
b. recheck in 1 year
<130/<85 |
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Patient presents with a BP of 118/77 in both arms. What is the follow-up procedure?
a. none b. recheck in 1 year c. recheck in 2 years d. confirm within 2 years e. refer immediately |
a. none
<120/<80 |
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Patient presents with a BP of 146/95 in both arms. What is the follow-up procedure?
a. none b. recheck in 1 year c. recheck in 2 years d. confirm within 2 years e. refer immediately |
d. confirm within 2 months (stage 1 hypertension)
140-159/90-99 |
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Patient presents with a BP of 180/110 in both arms. What is the follow-up procedure?
a. none b. recheck in 1 year c. recheck in 2 years d. confirm within 2 years e. refer immediately |
e. refer immediately
=>180/=>110 is stage 3 hypertension |
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What structure is not located in the anterior triangle of the neck?
a. external jugular b. thyroid gland c. carotid arteries d. trachea e. all of the above are in the anterior triangle |
a. external jugular
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T/F? The ethmoid bone forms part of the cranial vault
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False
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What cranial nerve supplies motor/sensory to the muscles of the jaw?
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CN V
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What cranial nerve gives motor innervation to the face?
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CN VII for muscles of facial expression and CN V for the muscles of mastication
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What cranial nerve gives sensation to the face?
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CN V
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Which salivary gland is NOT palpable from the exterior?
a. parotid b. sublingual c. submandibular d. a & c e. all of the above are palpable externally |
b. sublingual gland (floor of mouth)
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Soft, low pitched whoosing sounds created by blood moving through a narrow artery is called a ______.
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bruit
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______ aneurysm is the cause for tracheal tugging.
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Aortic
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What condition(s) cause tracheal deviation toward the healthy side?
a. Tumor b. Large atelectasis c. Pleural adhesions d. Pneumothorax |
a. tumor
d. pneumothorax |
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What condition(s) cause tracheal deviation toward the diseased side?
a. Tumor b. Large atelectasis c. Pleural adhesions d. Pneumothorax |
b. Large atelectasis
c. Pleural adhesions |
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What hormones are involved in either excess or deficiency in patients with gigantism?
a. excess Growth hormone (GH) b. decreased TSH, excess T3 and T4 c. decreased thyroid hormone d. adrenal hypofunction (decreased cortisol and aldosterone) e. excess cortisol ab. decreased dopamine |
a. excess growth hormone
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What hormones are involved in either excess or deficiency in patients with Grave's Disease?
a. excess Growth hormone (GH) b. decreased TSH, excess T3 and T4 c. decreased thyroid hormone d. adrenal hypofunction (decreased cortisol and aldosterone) e. excess cortisol ab. decreased dopamine |
b. decreased TSH, excess T3 & T4
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What hormones are involved in either excess or deficiency in patients with Addison's Disease?
a. excess Growth hormone (GH) b. decreased TSH, excess T3 and T4 c. decreased thyroid hormone d. adrenal hypofunction (decreased cortisol and aldosterone) e. excess cortisol ab. decreased dopamine |
d. adrenal hypofunction
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What hormones are involved in either excess or deficiency in patients with Cushing's Syndrome?
a. excess Growth hormone (GH) b. decreased TSH, excess T3 and T4 c. decreased thyroid hormone d. adrenal hypofunction (decreased cortisol and aldosterone) e. excess cortisol ab. decreased dopamine |
e. excess cortisol
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What hormones are involved in either excess or deficiency in patients with Parkinson's?
a. excess Growth hormone (GH) b. decreased TSH, excess T3 and T4 c. decreased thyroid hormone d. adrenal hypofunction (decreased cortisol and aldosterone) e. excess cortisol ab. decreased dopamine |
ab. decreased dopamine
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What hormones are involved in either excess or deficiency in patients with hypothyroidism?
a. excess Growth hormone (GH) b. decreased TSH, excess T3 and T4 c. decreased thyroid hormone d. adrenal hypofunction (decreased cortisol and aldosterone) e. excess cortisol ab. decreased dopamine |
c. decreased thyroid hormone
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Moon Facies and buffalo hump are two characteristics of ________ _______.
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Cushing's syndrome
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True/False? Cushing's syndrome is also known as hyperadrenal function.
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True
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True/False? Cushing's syndrome can be caused by a local tumor?
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True
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True/False? Cushing's syndrome can be identified by a deficiency in cortisol and aldosterone.
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False - Addison's
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A hypofunctioning adrenal gland along with skin that is tan might be a sign of what disease?
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Addison's disease
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Exopthalamos is a common characteristic in hyper or hypo thyroidism?
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hyper
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If a patient has hypothyroidism, a characteristic their hair might have is (fine/coarse) texture?
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coarse
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A woman's loss of menstruation could be related to hyper or hypo thyroidism?
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hyper
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Name the triad that manifests with Parkinson's Disease.
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Rigidity
Tremor Flexed posture |
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Which head and neck conditions cause skull enlargement?
a. Hashimoto's b. Addison's c. Acromegaly d. Hydrocephalus e. Gigantism |
c, d, e
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What type of headache can be bilateral?
a. Muscular tension headache b. Vascular Migrane headache c. Cluster headache |
a. muscular tension
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What type of headache commonly affects BOTH sexes?
a. Muscular tension headache b. Vascular Migrane headache c. Cluster headache |
a. muscular tension
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Which type of headache commonly causes visual changes (like flashing lights or blind spots?)
a. Muscular tension headache b. Vascular Migrane headache c. Cluster headache |
b. vascular migrane
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What type of headache can affect the eye with symptoms like ptosis and red eye?
a. Muscular tension headache b. Vascular Migrane headache c. Cluster headache |
c. cluster headache
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Males are more likely to get what type of headache than women (9 to 1 ratio)?
a. Muscular tension headache b. Vascular Migrane headache c. Cluster headache |
c. cluster headache
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Which type of headache does not have a prodromal period?
a. Muscular tension headache b. Vascular Migrane headache c. Cluster headache |
A & C
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Which type of headache often has side effects of nausea, vomiting and numbness?
a. Muscular tension headache b. Vascular Migrane headache c. Cluster headache |
b. vascular migrane
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What factor separates classic migrane from common migrane?
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Prodromal symptoms 30 minutes before migrane onset
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Between cluster headaches and migranes, which type is often located periorbital and/or temporal?
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cluster headaches
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Between cluster headaches and migranes, which type can last as short as 15 minutes?
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cluster headaches
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Between cluster headaches and migranes, which type actually intensifies upon exertion?
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migranes
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T/F? Bells Palsy is bilateral facial paralysis with sudden onset.
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False - unilateral
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T/F? Bell's Palsy is unilateral facial paralysis with sudden onset.
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True
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Differing from Bell's Palsy, what TWO muscles are often affected less during a CVA stroke?
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1. Frontalis
2. orbicularis oculi |
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The area where the upper and lower eyelids meet is called the
a. caruncle b. tarsal plate c. bulbar conjunctiva d. canthus e. palpebral conjunctiva |
d. canthus
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What lines the inner surface of the eyelids?
a. caruncle b. tarsal plate c. bulbar conjunctiva d. canthus e. palpebral conjunctiva |
e. palpebral conjunctiva
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What gives rigidity and shape to the eyelid?
a. caruncle b. tarsal plate c. bulbar conjunctiva d. canthus e. palpebral conjunctiva |
b. tarsal plate
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What structure contains sebaceous glands to lubricate the eye?
a. caruncle b. bulbar conjunctiva c. canthus d. palpebral conjunctiva |
a. caruncle
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The __________ glands in the eye are located with tarsal plates to provide sebaceous lubrication.
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Meibommian
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What is the name of the thin membrane that covers the front surface of the eye?
a. caruncle b. tarsal plate c. bulbar conjunctiva d. canthus e. palpebral conjunctiva |
c. bulbar conjunctiva
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What structure provides fluid and nutrition to the eye?
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choroid
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The corneal reflex test is testing what cranial nerve?
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CN V
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Papillary constriction is a functional assessment of what cranial nerve?
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CN III
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What bones do NOT form part of the orbit?
a. maxilla b. lacrimal c. sphenoid d. nasal e. ethmoid ab. zygomatic ac. occipital ad. parietal ae. palantine |
d. nasal
ac. occipital ad. parietal |
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What anterior eye structure is continuous with the sclera?
a. iris b. pupil c. optic disc d. anterior cornea e. all of the above |
anterior cornea
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What structure creates the "blind spot"?
a. iris b. pupil c. optic disc d. anterior cornea e. all of the above contribute |
c. optic disc
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How far away is the patient supposed to stand from the Snellen eye chart?
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20 feet
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The ciliary body and iris are continuous with what structure?
a. sclera b. choroid c. pupil d. anterior cornea |
b. choroid
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What is the name of the test being performed when you produce a corneal light reflection by shining a light on them?
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Hirschberg test
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During visual field testing, what direction should have the greatest field of vision? How many degrees?
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Temporal - 90 degrees
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If the corneal light reflex was asymmetrical, what follow-up test would be performed?
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cover-uncover test
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If the eye shows a few beats at the end point of nystagmus, is this acceptable?
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Yes as long as oscilliations stop
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What body part often is having a problem when sustained nystagmus is observed?
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brain
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If you observe yellow sclera, what condition is indicated?
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jaundice
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If a patient has thinning lateral margins of the eyebrows, what condition might they be experiencing?
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hypothyroid tendencies
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Down's Syndrome has a significant correlation with the __________ folds.
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epicanthal
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What is meant by PERRLA referencing the eye examination?
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Pupils Equal, Round, Reactive to Light, and Accommodation
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When the pupils are fixed and constricted, this is known as:
a. Miosis b. Mydriasis c. Anisoscoria d. Argyll-Robertson e. Adie's tonic pupil |
a. miosis
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If the pupils show to be fixed and dilated, this is known as:
a. Miosis b. Mydriasis c. Anisoscoria d. Argyll-Robertson e. Adie's tonic pupil |
b. mydriasis
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Unequal pupil size is called:
a. Miosis b. Mydriasis c. Anisoscoria d. Argyll-Robertson e. Adie's tonic pupil |
c. anisoscoria
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Small irregular pupils that react to near vision but not light is known as:
a. Miosis b. Mydriasis c. Anisoscoria d. Argyll-Robertson e. Adie's tonic pupil |
d. argyll-robertson
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When a unilateral pupil reacts slowly to light and accommodation, it is called:
a. Miosis b. Mydriasis c. Anisoscoria d. Argyll-Robertson e. Adie's tonic pupil |
e. adie's tonic pupil
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When you hold your finger a few inches away from the pt's nose and have the pt alternate looking at the finger and a distant object, you are testing for:
a. Light reflex b. Fixation c. Accommodation |
c. accommodation
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I am testing direct and consentual pupillary constriction by doing what test?
a. Light reflex b. Fixation c. Accommodation |
a. light reflex
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A person with a "lazy eye" has what condition?
a. scotoma b. glaucoma c. strabismus d. nystagmus e. bitemporal hemianopsia |
c. strabismus
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What cranial nerve is involved with herpes zoster opthalmicus?
a. III b. IV c. V1 d. V2 e. VI |
c. V1
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A temporary and painless loss of vision in one eye is called:
a. scotoma b. glaucoma c. strabismus d. amaurosis fugax e. bitemporal hemianopsia |
d. amaurosis fugax
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A permanent or temporary area of depressed or absent vision, aka a blind spot, is known as:
a. scotoma b. glaucoma c. strabismus d. nystagmus e. bitemporal hemianopsia |
a. scotoma
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T/F? A cause of glaucoma is decreased intraocular pressure within the eye.
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False - increased pressure
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T/F? A cause of glaucoma is increased intraocular pressure within the eye.
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True
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Glaucoma can be caused by:
a. increased intraocular pressure b. increased production of aqueous humor c. inadequate drainage at the canal of schlemm d. all of the above e. none of the above |
d. all of the above
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A pituitary tumor at the optic chiasm causes:
a. scotoma b. glaucoma c. strabismus d. nystagmus e. bitemporal hemianopsia |
e. bitemporal hemianopsia
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Normal vision where the cornea and lens focus light correctly on the retina is called:
a. emmetropia b. myopia c. hyperopia d. astigmatism |
a. emmetropia
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When the cornea and lens are asymmetrical and light is focused in several places, this is called:
a. emmetropia b. myopia c. hyperopia d. astigmatism |
d. astigmatism
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Which of the following means being nearsighted?
a. emmetropia b. myopia c. hyperopia d. astigmatism |
b. myopia
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Which of the following means light is focused ANTERIOR to the retina?
a. emmetropia b. myopia c. hyperopia d. astigmatism |
b. myopia (aka nearsighted)
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T/F? Being nearsighted means light is focused posterior to the retina.
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False - anterior
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T/F? Being nearsighted means light is focused anterior to the retina.
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True
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Which of the following also means being far-sighted?
a. emmetropia b. myopia c. hyperopia d. astigmatism |
c. hyperopia
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Which of the following means light is focused POSTERIOR to the retina?
a. emmetropia b. myopia c. hyperopia d. astigmatism |
c. hyperopia
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T/F? Being far-sighted means light is focused posterior to the retina
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True
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T/F? Being far-sighted means light is focused anterior to the retina
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False - posterior
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What structure contributes more to refraction of light entering the eye?
a. cornea b. lens |
a. cornea
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What structure separates the anterior and posterior chamber of the eye?
a. lens b. iris c. sclera d. cornea e. retina |
b. iris
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The reflection of light on the _______ causes the "red reflex".
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retina
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What is the first sensation lost with diabetic peripheral neuropathy?
a. temperature b. vibration c. texture d. pain e. all of the above |
b. vibration
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What are the names of the two tests for meningitis?
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Brudzinski's and Kernig's (bilateral and symmetrical)
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What is the most common cause of Cushing's syndrome?
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iatrogenic
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What type of headaches are most common?
a. Vascular migrane b. Cluster c. Tension d. Encephalitis |
c. tension
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What is the name of the condition/syndrome/disease with the symptoms of "Can't see, can't pee, can't dance with me"?
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Ryder Syndrome
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Ischemic stroke is the __ leading cause of death.
a. 1st b. 2nd c. 3rd d. 5th e. 14th |
c. 3rd
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The subclavian steel syndrome affects the _____ more than the _____. (R or L?)
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affects left more than the right
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Excess vitamin __ may cause loose stools.
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C
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Ontogenesis perfecta has a _____ sclera coloring.
a. clear b. blue c. yellow d. reddish e. brown |
b. blue
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The afferent corneal light reflex tests what cranial nerve?
a. II b. III c. V d. VI e. X |
a. II
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The efferent corneal light reflex tests what cranial nerve?
a. II b. III c. V d. VI e. X |
b. III
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Who said "if you listen to your patient long enough, they will tell you what's wrong with them?"
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Sir William Oster
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