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106 Cards in this Set
- Front
- Back
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Preventative Maintenance
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Imminuzations
BP Lipid panel Screen for Breast Ca (mammography) Colorectal Ca (colonoscopy) Cervical ca (pap smear) Testicular ca (TSE) Osteoporosis (DEXA) |
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Anemia, Fe deficiency
PE? p 924 |
HEENT, heart, abdomen, nails, pelvic, rectal
Eyes: Pale conjunctiva? Mouth: Corners? Stomatitis?Cheilosis? Glossitis? Plummer Vinson syndrome? Cardiac: tachy, flow murmurs Abdomen: Masses, splenomegaly Pelvic: vaginal bleeding Rectal: stool guiac and DRE, bleeding melena, hemorrhoids, masses. Skin: Pallor, Nails: kiolonychia |
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PE for hypertension? p 485
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HEENT, Chest, heart, extremities, abdomen, neuro
Head: temporal arteries Eyes: funduscopic exam-papilledema, retinal exudates, hemorrhages, or retinopathy, Neck: distended neck veins, carotid bruits, thyromegaly Lungs: auscultate for abnormal lung sounds (wheezing, crackles, rales) Cardiac: Apical Impulse, arrhythmias, S3,S4,murmurs, or a displaced PMI, JVD, and pulses Extremities: (No C,C,E) Color, temp, edema, diminished hair growth? Abdomen: listen for aortic, renal, illiac bruits, aortic pulsation, palpate for masses or pain, enlarged kidneys, liver size Neuro: complete neuro exam for s/s stroke or TIA |
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Diabetes Mellitus PE? p 165
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General, HEENT, Abdomen, Feet, Neuro, Skin
Eyes: funduscopic eye exam to rule out cataracts, retinopathy or retinal hemorrhage Mouth: Thrush Thyroid Heart: perform a complete exam to chek for abnormalities Abdomen: Liver Enlargement? Feet: comprehensive ft exam to check vascular status, skin condition, infect, sensation and proprioception (monofilament, tuning fork) Neuro: eval for peripheral neuropathy Skin: acanthosis nigricans, inspect for signs of infections at insulin and FS sites. |
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Asthma PE? p 392
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HEENT, chest, skin
HEENT: examine nasal mucosa and oropharyngeal mucosa for abnormalities Chest: Wheezing, crackles, rales? Decreased aeration with expiratory phase> inspiratory phase. Skin: Inspect for rashes or hives |
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Bronchitis/ pneumonia
PE? p 404 |
HEENT, Lungs, heart, skin
Grunting? Nasal flaring? Lungs: decreased BS Heart: complete heart exam Skin:Skin turgor and capillary refill for hydration status |
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Chest Pain
PE? p 462 |
HEENT, Chest, heart, Abdomen, musculoskeletal
General: observe for signs of anxiety or nervousness HEENT: JVD? Carotid pulses, bruits? Chest: complete chest exam Heart:complete Abdomen: Pain? Bruits? Musculoskeletal: examine arms, shoulders and chest wall for tenderness |
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PE for hyperlipidemia? p181
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BP, Ht &Wt, Neck, heart, abdomen, neuro, skin
Neck: carotid bruits, Thyroid Heart: Perform comp. ht exam Extremities: Pulses? C/C/E Lungs Abdomen: listen for renal bruits, Hepatomegaly, Splenomegaly Neuro Perform a comp. neuro exam if signs of a stroke or TIA are present Skin: xanthomas near eyelids or over extensor areas of tendons |
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PE Osteoarthritis? p 836
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Musculskeletal
ROM of joints Herbeden's nodes Bouchard's nodes Joint deformities/ enlargements Pain with tenderness w/ movement inspect for local trauma, erythema, or streaks (septic arthritis) Crepitus and joint instability effusion/ synovitis |
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Headache PE? p 894
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HEENT, Neuro
HEENT: Lacerations? Hemotympanum, Battle's sign, raccoon eyes, clear otorrhea or rhinorrhea? Scalp tenderness(temp art) unequal pupils, papilledema, TMJ tenderness, nuchal rigidity |
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Appendicitis
PE? p 535 |
Abdomen, rectal, pelvic exam
Abdomen: Rebound? Guarding?(peritoneal irritation) Mc Burney's point Rovsing's sign Obturator Sign Psoas sign |
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Dizziness PE?
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HEENT, Heart, NEURO
HEENT: Perform a complete ears, nose, throat and neck exam? Vertical/ Horizontal or rotatory nystagmus? Heart: arrhythmias or abnormal heart sounds Neuro: Complete exam , Cerebellar exam, Hallpike exam, Sensory exam |
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Obesity PE? p 106
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HEENT, Abdomen, skeletal
HEENT: check thyroid for enlargement Abdomen: measure waist circumference and palpate for masses skeletal: joint crepitus, tenderness or deformity |
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Conjunctivitis PE? p 326
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HEENT
check PERRLA Photophobia? Hyperemia (which may suggest iritis)? Visual problems? Visual acuity? Conjunctival discharge? Color? Consistency? Debris on eyelashes? Lid edema:Vesicles? Allergic shiners? Nasal Congestion? Mucopurulent discharge? Invert eyelids to search for andy foreign body? |
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Constipation PE? p 555
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HEENT, Abdomen, Rectal, Skin
HEENT: Check for enlarged thyroid gland and goiter? Dry mucous membranes or painful oral lesions? Abdomen: masses? tenderness or distension? hypoactive Bowel sounds? Rectal: hemorrhoids, masses, fissures or impatction, stool guaiac Skin: check skin turgor, capillary refill, an signs of dry skin |
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Allergic Rhinitis
PE? p 362 |
HEENT, Lungs, Skin
Nasal mucosa pale? boggy? clear rhinnorhea? red mucosa? allergic shiners? cobblestoning? Horizontal nasal crease? Nasa salute? Lungs? Wheezing (asthma) Skin rash or hives? |
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BMI parameters
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Body Mass Index
•Underweight = <18.5 •Normal weight = 18.5–24.9 •Overweight = 25–29.9 •Obesity = 30 or greater |
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History that's really impt to ask
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PM Hx
Allergies Meds LMP Tobacco, ETOH, or drug use |
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Cerebellar exam consists of?
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Check gait, Romberg, and finger to nose.
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Osteoperosis PE? p 840
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Osteoperosis PE?
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RA PE? p 851
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RA PE?
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Dementia/ Delirium PE?
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General: Check if ppt is alert and oriented.
HEENT: signs of head trauma Chest/heart: complete cardiopulmonary exam Neuro: perform a minimental status exam and compare to previous; Psychological exam and a complete neuro exam Evaluate for aphasia, agnosia, apraxia or anomia? |
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GERD PE? p 570
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Cardio, Lungs, Abdomen
Abdomen: midepigastric tenderness to palpation hyperactive bowel sounds are seen in te setting of a bleeding ulcer peritoneal signs (rebound, guarding, hypoactive bowel sounds) may be elicited when there is gastric perforation from an ulcer Rectal: guiac positive (bleeding ulcer) |
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Obdurator's sign
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1st the pt lies on back with the rt hip flexed at 90 deg. The examiner then holds the pt's rt ankle in his rt hand. With his left hand, the examiner rotates the hip by moving the rt knee to and away from the patient's body. This is flexion and internal rotation of the hip.
The technique is done on each leg in succession. aka Cope sign, is an indicator of irritation to the obturator internus muscle. |
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Skin PE for hypothyroidism?
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-rough, cool skin with a doughy consistency
-orange-yellow coloration -myxedema? -brittle hair and nails, pitting of the fingernails |
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Neuro PE for hypothyroidism?
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delayed relaxation of DTR
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Abdomen PE for hypothyroidism?
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Decreased or absent bowel sounds on auscultation secondary to ileus
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Chest for hypothyroidism?
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Nipple discharge can be present on breast exam
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GI Bleed?
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HEENT,Cardio, Lungs, Abdomen, Rectal, Skin
General: Pale appearance HEENT: Check for blood in the mouth nares or oropharynx Inspect for scleral icterus, which can be present in liver dx Cardio: tachy or flow murmur may be audible in high output states abdomen: inspect for caput medusa, which is typically present in portal HTN hyperactive bs peritoneal signs, ascites, masses or hepatosplenomegaly Rectal: check for guaiac post stools, rectal masses or hemorrhoids skin: findings suggestive of liver dx include jaundiced skin, palmar erythema or spider angiomas Neuro: AMS, flapping (asterixis) |
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Heart PE for hypothyroidism? p 199
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Bradycardia?
Muffled heart sounds, suggesting pericardial effusion PMI could be displaced indicating an enlarged heart |
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HEENT PE for hypothyroidism?
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Check for periorbital puffiness or loss of lateral third of eyebrows.
Palpate the thyroid for possible goiter |
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Hypothyroidism PE?
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HEENT, heart, chest abdomen, neuro, skin
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Name for fingernail separation from nail bed?
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Onycholysis
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Murphy's sign?
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Pain in the RUQ that halts inspiration upon palpation.
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Neuro PE for hyperthyroidism?
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Elicit DTR which are usually brisk in hyperthyroidism
inspect hands for fine tremor |
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Hemotympanum
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refers to the presence of blood in the tympanic cavity of the middle ear. Hemotympanum is often the result of basilar skull fracture
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Skin PE for hyperthyroidism?
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Moist, warm, silky skin along with fine, silky hair are common
check for fingernail separation from nail bed |
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Battle's sign
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mastoid bruising
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Heart PE for hyperthyroidism?
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hyperdynamic chest or flow murmur?
irregular rate suggests Afib |
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Hyperthyroidism PE? p 193
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HEENT, heart, skin, neuro
HEENT: diplopia, lid lag / proptosis tongue tremor?fasciculations? enlargement of thyroid / palpable nodules thyroid bruits? |
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Neuro check for headache consists of?
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CN, visual fields, motor and sensory exams, cerebellar deficits, alternating hands, finger to nose and gait
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Basilar skull fracture can be suggested by?
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hemotympanum, Battle's sign, raccoon eyes, clear otorrhea or rhinorrhea
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Papilledema suggests?
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Increased ICP
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Signs of meningitis?
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Nuchal rigidity Brudzinski
Headache Kernigs Photophobia |
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You may see unequal pupils with what type of headache?
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cluster , ICP
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Cholelithiasis/Cholecystitis
PE? |
General, Chest, Abdomen
General:note obesity and if jaundice? Chest: auscultate chest for RL lobe pnuemonia? Abdomen: epigastric or RUQ tenderness, rebound, or guarding? Murphy's sign?Charcot's triad? Palpable gallbladder may indicate cancer. |
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Cholangitis?
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Ascending cholangitis is caused by bacteria, and causes pain, jaundice, and fever. The bacteria usually originate from a preceding choledocholithiasis.
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Fibromyalgia
PE? |
Cardio, Lungs, Musco
General: May be anxious or have a flat affect Musculoskeletal: tenderness by digital palpation over 18 paired trigger points |
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proptosis?
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Eye proptosis is a condition resulting in forward displacement and entrapment of the eye from behind by the eyelids. The condition is also known as eye dislocation and eye luxation/ Exophthalmos
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myxedema
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infiltration of the skin by mucopolysaccharides, givnig it a waxy or coarsened appearance. Myxedematous skin is seen part in pts with hypothyroidism
pretibial myxedema of the anterior sufface of the legs folloing hyperthyroidism and exopthalmos |
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Stomatitis?
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is an inflammation of the mucous lining of any of the structures in the mouth, which may involve the cheeks, gums, tongue, lips, throat, and roof or floor of the mouth.
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What are the 18 paired trigger points for palpation for musculo tenderness for fibromyalgia?
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B/L suboccipital muscle insertion
...... |
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Cheilosis?
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Angular cheilitis (also called cheilosis or angular stomatitis) is an inflammatory lesion at the labial commissure, or corner of the mouth, and often occurs bilaterally. The condition manifests as deep cracks or splits. In severe cases, the splits can bleed when the mouth is opened and shallow ulcers or a crust may form.
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Epididymitis/Prostatitis?
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General: Pt may be ill appearing
Urogenital:Check testicles Testicular or epididymal tenderness with palpatio may be present. Phren's test, Inguinal lymph nodes, Urethral discharge , eval external genitals for lesions Rectal: DRE |
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Glossitis?
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inflammation or infection of the tongue. It causes the tongue to swell and change color. Finger-like projections on the surface of the tongue (papillae) may be lost, causing the tongue to appear smooth.
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retching
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strong involuntary effort to vomit.
May precede vomitting |
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Plummer Vinson syndrome?
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(aka Paterson-Brown-Kelly syndrome).
conditon which may have upper esophageal web, iron deficiency anemia, glossitis, and cheilosis |
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hematemesis
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vomiting of blood
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Basophilic stippling?
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observation found when observing a blood film, where erythrocytes display small dots at the periphery. Dots represent accumulations of rRNA and are always pathological.Assoc w/ conditions like: Sideroblastic anemia, Lead poisoning,
Beta thalassemia, Megaloblastic anemia. |
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Peritoneal signs?
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rebound, guarding, hypoactive BS
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hemosiderosis?
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is a form of iron overload disorder resulting in the accumulation of hemosiderin.
Pict of kidney cells with hemosiderin |
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What can cause haemosiderosis?
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Hemosiderin deposition in the lungs is often seen after diffuse alveolar hemorrhage, which occurs in diseases such as Goodpasture's syndrome, Wegener's granulomatosis, and idiopathic pulmonary haemosiderosis. Mitral stenosis can also lead to pulmonary hemosiderosis.
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Caput medusae ?
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Caput medusae is the appearance of distended and engorged paraumbilical veins, which are seen radiating from the umbilicus across the abdomen to join systemic veins.
Assoc with portal htn |
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hyperemia?
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engorgement; an excess of blood in a part.
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xanthomas?
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is a deposition of yellowish cholesterol-rich material in tendons or other body parts in various disease states
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Location of mc burney's point?
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McBurney's point is the name given to the point over the right side of the abdomen that is one-third of the distance from the ASIS (anterior superior iliac spine) to the umbilicus (the belly button). This point roughly corresponds to the most common location of the base of the appendix where it is attached to the cecum.
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aphasia?
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fluent aphasia (Wernicke’s) and non-fluent (Broca’s aphasia).
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agnosia?
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is a loss of ability to recognize objects, persons, sounds, shapes, or smells while the specific sense is not defective nor is there any significant memory loss.
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anomia?
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problem with word finding. Impaired recall of words with no impairment of comprehension or the capacity to repeat the words.
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Broca’s aphasia
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People with Broca’s aphasia typically understand the speech of others fairly well. often aware of their difficulties and can become easily frustrated. People with Broca’s aphasia often have right-sided weakness or paralysis of the arm and leg because the frontal lobe is also important for motor movements.
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Apraxia?
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Apraxia: inability to execute a voluntary movement despite being able to demonstrate normal muscle function.
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Complications of Choledocholithiasis?
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This obstruction may leads to jaundice, elevation in alkaline phosphatase, increase in conjugated bilirubin in the blood and increase in cholesterol in the blood. It can also cause acute pancreatitis and ascending cholangitis.
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Hallpike manuever?
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An abnormal test result means that you had vertigo or nystagmus during the test. It is likely that the vertigo is caused by an inner ear or brain problem, depending on the way you reacted to the test. Central vertigo is caused by a problem inside the brain, and peripheral vertigo is caused by a problem with the inner ear or the nerve leaving the inner ear.
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Metabolic syndrome can be diagnosed with what criteria's met?
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at least 3
Central obesity 9Men waist >40", women waist >35") hypertriglyceridemia>/=150mg/dl Low HDL men<40 mg Women<50 mg/dl Hypertension>/= 130/85 fasting glucsoe impairment>/=110 mg/dl |
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Adenitis?.
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Adenitis is a general term for an inflammation of a gland[1] or lymph node.
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Pharyngitis/ Tonsillitis PE?
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HEENT, Neck, Skin
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Pharyngitis/ Tonsillitis PE for HEENT?
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Palatal petechiae, beefy red tonsillar appearance, exuddates and a strawberry tongue.
vesicles r ulcerations on the oral mucosa can be present in herpes and coxsackie infections unilateral soft palate swelling with displacement of uvula is evident in peritonsillar abcess |
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Pharyngitis/ Tonsillitis PE for Neck?
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cervical adenitis
auscultate to chek for stridor, which can be present in H influ |
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Pastia's lines?
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Pastia's lines can also be found in scarlet fever.
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Pharyngitis/ Tonsillitis PE for Skin?
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Inspect for the presence of a sandpaper rash (which arises from the toxin of group A strep)
Linear petchiae on the body folds of the neck, groin, acilla, antecubital fossa, and popliteal fossa called Pastia's lines can also be found in scarlet fever. Inspect palms and soles for vsicles when coxsackie infect is suspected. |
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orbital cellulitis
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eyes for periorbital swelling, erythema and restriction of extraocular movements
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Sinusitis PE?
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HEEENT
Palpate for tenderness of frontal & Maxillary sinuses opacity of te affected sinus on transillumination nasal polyp or diviated nasal septum swollen turbinates with purulent yellow or green discharge oropharynx may have cobblestoing or visible steaks of mucopurulent discharge (Post Nasal Drip) Inspect the eyes for periorbital swelling, erythema and restriction of extraocular movements (orbital cellulitis) |
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Urinary Inct PE?
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Abdomen, Pelvic, Rectal, Neuro
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Urinary Inct PE for abdomen?
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masses?
suprapubic tenderness? |
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Urinary Inct PE for pelvis?
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atrophy of urethra or vaginal rugae may be seen in menopausal women
assess pelvic floor muscle strenght and check for cystocele, rectocele, or uterine prolapse check for leakage of urine during valsalva's maneuver |
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Urinary Inct PE for rectal?
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perform DRE and check for enlarged (BPH), boggy or tender (prostatis) prostate?
Mass? Stool impaction? Assess sphincter tone: may bebe decreased in spinal cord injury |
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Urinary Inct PE for neuro?
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Examine lower extemity senasation, strength and reflexes (anal wink)
Perform minimental status exam to assess for possible dementia |
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PE for UTI?
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Abdomen, Back, GU, Rectal
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PE of ab and back for UTI?
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Abdomen: check for surgical scars and suprapubic tenderness
Back: Palpate for CVAT |
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For subjective data, what is dysuria,
oliguria, pyuria? |
-burning in urin(as with acute cystitis, prostatitis, urethritis)
– diminished quantity(<400ml/24h) –pus with urin |
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Prostatitis/ Epididymitis PE?
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urogenital
check testicles testicular or epididymal tenderness with palpation may be present +Prehn's test examine inguinal lymph nodes check for urethral discharge eval external genitals for lesions Rectal DRE for enlargement, tenderness or bogginess of the prostate |
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+Prehn's test
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reduced testicular pain with elevation of scrotum above symphysis in epididymitis (in torsion, there is incereased pain)
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It is elicited by performing the psoas test by passively extending the thigh of a patient lying on their side with knees extended, or asking the patient to actively flex their thigh at the hip? medical sign that indicates irritation to the iliopsoas group of hip flexors in the abdomen, and consequently indicates that the inflamed appendix is retrocaecal in orientation (as the iliopsoas muscle is retroperitoneal).
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Psoas sign
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Coxsackie infection?
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Hand foot and mouth dx (viral)
Type A viruses cause herpangina (painful blisters in the mouth, throat, hands, feet, or in all these areas). It usually occurs in children (age 10 and under), but adults can also develop the condition. Type A also causes conjunctivitis Type B viruses cause epidemic pleurodynia (fever, lung, and abdominal pain with headache that lasts about two to 12 days and resolves). Pleurodynia is also termed Bornholm disease. ). Both types of viruses (A and B) can cause meningitis, myocarditis, and pericarditis, but these occur infrequently |
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herpangina
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herpangina (painful blisters in the mouth, throat, hands, feet, or in all these areas).
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conjunctivitis
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(inflammation of the eyelids and white area of the eye).
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term for spoon nails?
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kiolonychia
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What are the requirements for fed court diversity jurisdiction
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1. action between citizens of different states or a citizen of a state and a citizen of a foreign country (alienage)
2. amount in controversy exceeds $75000 |
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Most frequent signs of DM?
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polydypsia (excessive thirst)
Polyphagia Polyuria |
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Go over requirements of DM?
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DM
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5 signs of acute arterial occlusion? p 523
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5 P's
Pallor Pain Pulselessness Paresthesia Paralysis |
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Choledocholithiasis?
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presence of gallstones in the common bile duct. This condition causes jaundice and liver cell damage, and is a medical emergency, requiring the endoscopic retrograde cholangiopancreatography (ERCP) procedure or surgical treatment.
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ABI results p 523
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<0.5 severe dx
0.5-0.89 significant arterial occlusive dx, exercise claudication 1.0-1.1 WNL |
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xanthomas?
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cutaneious or subcutaneous papules, plaques, or nodules that may develop in the tendons, extensor surfaces of the extremities, buttocks, knees, skin folds, scars and eyelids
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What is the difference in how gastroenteritis and appendicitis presents on
PE? |
In appendicitis, pain typically presents before vomiting, the reverse being true in acute gastroenteritis.
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Hallpike exam elcites?
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Nystagmus or vertigo
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