Term
| What are some signs of dehydration? |
|
Definition
-Tachychardia
-Weak pulse
-Turgor on abdomen |
|
|
Term
| What are some signs of protein deficiency? |
|
Definition
-Edema in arms and legs
-Distension/ascites of abdomen
-Muscle wasting and flaccidity |
|
|
Term
| What are the measurements of BMI? |
|
Definition
Underweight: <18.5
Normal: 18.5-24.9
Overweight: 25.0-29.9
Obesity I: 30.0-34.9
Obesity II: 35.0-39.9
Extreme Obesity III: >40 |
|
|
Term
| What laboratory studies are important in nutritional assessment? |
|
Definition
-Hemoglobin
-Hematocrit
-Cholesterol
-Triglycerides
-Total Lymphocyte count
-Skin Testing
-Serum Proteins
-Nitrogen balance
-Creatinine-height index |
|
|
Term
|
Definition
| Protein-calorie malnutrition |
|
|
Term
|
Definition
|
|
Term
| Abnormal findings caused by nutritional deficiencies |
|
Definition
-Scorbutic gum: Vit C deficiency
-Follicular hyperkeratosis: Vit A deficiency
-Bitot's Spots: Vit A deficiency
-Rickets - Vit D, Calcium deficient |
|
|
Term
| What are the 7 components of a Comprehensive Adult Health History? |
|
Definition
1. Identifying data and source of history
2. Chief Complaints
3. Past History
4. Family History
5. Review of Systems
6. Health Patterns
7. History of present illness |
|
|
Term
|
Definition
| Cutting down, Annoyance if criticized, Guilty feelings, Eye-openers (2 or more of these suggest misuse) |
|
|
Term
| What are common or concerning symptoms when taking an integumentary history? |
|
Definition
-Rash
-Nonhealing lesions
-Moles
-Lesions
-Bruising (ecchymosis)
-Hair loss |
|
|
Term
| What are some external variables that can influence skin color? |
|
Definition
-Emotional states
-Temperature
-Cigarette smoking
-Prolonged elevation/dependent position of extremities
-Prolonged inactivity |
|
|
Term
| What are the 3 degrees of a burn? |
|
Definition
1st Degree: red, painful, blanches with pressure, no blistering
2nd Degree: blisters, redness, pain, raw surfaces (partial thickness or to dermis layer)
3rd degree: skin white or charred, not painful (full thickness, all skin elements destroyed) |
|
|
Term
|
Definition
| small flat spot, up to 1.0cm |
|
|
Term
|
Definition
| flat spot 1.0cm or larger |
|
|
Term
|
Definition
| elevated superficial lesion 1.0cm or larger |
|
|
Term
|
Definition
| elevated spot, up to 1.0cm |
|
|
Term
|
Definition
| marble-like lesion larger the 0.5cm, often deeper and firmer than papule |
|
|
Term
|
Definition
| Nodule filled with expressible material, either liquid or semisolid |
|
|
Term
|
Definition
| Somewhat irregular, relatively transcient, superficial area of localized skin edema |
|
|
Term
|
Definition
| Up to 1.0cm, filled with serous fluid |
|
|
Term
|
Definition
| 1.0cm or larger, filled with serous fluid |
|
|
Term
|
Definition
| Thin flake of dead exfoliated epidermis |
|
|
Term
|
Definition
| Dried residue of skin exudates such as serum, pus, or blood |
|
|
Term
| What are the types of pain? |
|
Definition
-Nociceptive: pain r/t tissue damage; responsive to inflammatory mediators
-Neuropathic: Direct or indirect injury to peripheral or CNS
-Idiopathic: without etiology |
|
|
Term
| What are the 3 types of nociceptive pain? |
|
Definition
Visceral: large or deep interior organs
Deep somatic: blood vessels, muscle, joints, tendons, bone
Cutaneous: skin |
|
|
Term
|
Definition
| Test for carpal tunnel, have patient put hands in praying upside down, if they feel numbness before 1 min it is positive |
|
|
Term
| What are two reference lines you would use on the posterior thorax? |
|
Definition
Vertebral line
Midscapular line |
|
|
Term
| What are the two reference lines you would use on the lateral thorax? |
|
Definition
Anterior axillary line (AAL)
Midaxillary line (MAL)
Posterior axillary line (PAL) |
|
|
Term
| What anterior rib do the lower lungs rest near? |
|
Definition
|
|
Term
| Inspiration is primarily facilitated by which muscles? |
|
Definition
| Diaphragm and intercostal |
|
|
Term
|
Definition
| difficulty breathing while recumbent |
|
|
Term
|
Definition
|
|
Term
| Paroxysmal Nocturnal Dyspnea |
|
Definition
| difficulty breathing that awakens patient |
|
|
Term
| What does it mean when fremitus is decreased during palpation? |
|
Definition
| When anything obstructs transmission of vibrations (e.g. obstructed bronchus, pleural effusion, pneumothorax, or emphysema) |
|
|
Term
| Name the different types of percussion notes. |
|
Definition
Resonance: over normal lung
Hyperresonance: over hyperinflated lung
Flatness/Dullness: over dense tissue or bone
Tympany: thing "tight drum" |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| gook in big airways; like snoring or clearing mucous |
|
|
Term
|
Definition
| low grating noise in peripheral and lateral chest; cough does not clear, noticed on inspiration/expiration; Plurisy |
|
|
Term
| A patient coughing at night signifies what respiratory disease? |
|
Definition
|
|
Term
| What are some symptoms of TB? |
|
Definition
| Weight loss, night sweats, bloody sputum |
|
|
Term
| What are the anatomical landmarks for the lungs on the anterior chest? |
|
Definition
-Lung apices (apex) is 3-4cm about clavicle
-Lower lungs rest on diaphragm at 6th rib, midclavicular line |
|
|
Term
| What are the anatomical landmarks for the lungs on the posterior chest? |
|
Definition
-Apices near C7
-Lower lungs near T10
-Trachea bifurcates at T4 |
|
|
Term
| List the percussion note, adventitious sounds and tactile fremitus/transmitted voice sounds in early left sided HF. |
|
Definition
1. Resonant
2. Late inspiratory crackles in dependent portion of lungs, possibly wheezes
3. Normal |
|
|
Term
| List the percussion note, adventitious sounds, and tactile fremitus/transmitted voice sounds in consolidation. |
|
Definition
1. Dull over the airless area
2. Late inspiratory crackles over involved area
3. Increased over area with bronchophony, egophony, and whispered pectoriloquy |
|
|
Term
| List the percussion note, adventitious sounds, and tactile fremitus/transmitted voice sounds for atelectasis (Lobar obstruction). |
|
Definition
1. Dull over airless area
2. None
3. Usually absent when bronchial plug persists |
|
|
Term
| List the percussion note, adventitious sounds, and tactile fremitus/transmitted voice sounds in pleural effusion. |
|
Definition
1. Dull to flat over fluid
2. None, except possible pleural rub
3. Decreased to absent, but may be increased toward top of effusion |
|
|
Term
| List the percussion note, adventitious sounds, and tactile fremitus/transmitted voice sounds in pneumothorax. |
|
Definition
1. Hyperresonant or tympanic over pleural air
2. None except possible pleural rub
3. Decreased to absent over pleural air |
|
|
Term
| List the percussion note, adventitious sounds, and tactile fremitus/transmitted voice sounds in COPD. |
|
Definition
1. Diffusely hyperresonant
2. None, or crackles, wheezes, and rhonchi of associated chronic bronchitis
3. Decreased |
|
|
Term
| List the percussion note, adventitious sounds, and tactile fremitus/transmitted voice sounds in asthma. |
|
Definition
1. Resonant to diffusely hyperresonant
2. Wheezes, possibly crackles
3. Decreased |
|
|
Term
|
Definition
| Fluid accumulates in the pleural space and separates air-filled lung from the chest wall, blocking the transmission of sound |
|
|
Term
|
Definition
| Slowly progressive disorder in which the distal air spaces enlarge and lungs become hyperinflated. Chronic bronchitis also associated |
|
|
Term
|
Definition
| Widespread narrowing of the tracheobronchial tree diminishes air flow to a fluctuating degree. During attacks, air flow decreases further, and lungs hyperinflate |
|
|
Term
| How do you measure for JVD? |
|
Definition
-Position bed at 30-45 degree angle and look for pulsations and fullness
-A normal reading the vein goes down as the head goes up = not stressed |
|
|
Term
| What would central cyanosis indicate? |
|
Definition
| Poor arterial circulation |
|
|
Term
| What would periperal cyanosis indicate? |
|
Definition
| Peripheral vasoconstriction |
|
|
Term
| What are you hearing during the "Lub (S1)" part of the heart sound? |
|
Definition
| The closure of the tricuspid and mitral vavle (AV valves) |
|
|
Term
| What are you hearing during the "Dub" (S2) part of the heart sound? |
|
Definition
| Closure of aortic and pulmonary valves (SL valves) |
|
|
Term
| What is a Split S2 (physiologic split)? |
|
Definition
| Aortic valve closes earlier than pulmonic valve during inspiration |
|
|
Term
| What is normal for Split S2? |
|
Definition
-It is normal to hear in athletes < 40 y.o.
-Best heard at base of heart (Mitral, Pulmonic)
-Louder on reclining and disappears during slow breathing or holding breath |
|
|
Term
| What is normal for Split S2? |
|
Definition
-It is normal to hear in athletes < 40 y.o.
-Best heard at base of heart (Mitral, Pulmonic)
-Louder on reclining and disappears during slow breathing or holding breath |
|
|
Term
| What is an abnormal split? |
|
Definition
-Occurs in expiration
-Stays when sitting up |
|
|
Term
|
Definition
-S3 occurs when ventricles are resistant in early rapid filling phase = protodiastole
-Not varying with respiration; persists when sitting upright, increases with isotonic exercise |
|
|
Term
| Who would you expect to have an S3 sound? |
|
Definition
-Young adults, children
-Increased heart rate
-Late pregnancy |
|
|
Term
| What would indicate an abnormal S3 sound? |
|
Definition
-Older adult
-Hypertension
-Volume overload (CHF)
-Mitral Regurg
-High output states (thyroid, anemia) |
|
|
Term
|
Definition
| Occurs from resistance to filling at end of disatole (at prestole) |
|
|
Term
| List the heart murmur grades: |
|
Definition
I - Very hard to hear
II - Quiet but heard with stethoscope
III - Moderately loud, without a thrill
IV - Loud, may have thrill
V - Very loud, definite thrill, can be heard with stethoscope partly off chest
VI - Heard without stethoscope on chest, obvious thrill |
|
|
Term
| What does Homen's test look for? |
|
Definition
| DVT (but is only 35% accurate) |
|
|
Term
| What are the symptoms of PAD? |
|
Definition
-Pain upon limb elevation (arterial blood cannot get to muscle)
-Pain increased with walking (intermittent claudication)
-Can tell how bad PAD is by how far they can walk
-Increase of pain at at night
-Increase of pain with cool temperature |
|
|
Term
| What are the anterior landmarks for location of the normal adult heart? |
|
Definition
| From the 2nd to 5th intercostal space and from the right border of the sternum to the left mid-clavicular line |
|
|
Term
| Where is the anatomical location of the apical impulse? |
|
Definition
| 5th intercostal space, mid-clavicular line |
|
|
Term
| What are the functions of the lymphatic system? |
|
Definition
1. Recycle and conserve fluids and plasma proteins
2. Part of immune system pathway: lymph nodes
3. Absorb lipids from the intestinal tract |
|
|
Term
| List the superficial lymph nodes available for direct examination. |
|
Definition
-Cervical
-Axillary
-Inguinal: upper and lower |
|
|
Term
| What would be worrisome findings during a lymphatic assessment? |
|
Definition
-Prolonged swelling over 1.5cm wide
-Widespread adenopathy
-Multiple positive history points |
|
|
Term
|
Definition
| fatty thickening in walls of arteries |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Alternating force of pulse; almost always indicates severe left-sided heart failure and is usually best felt by applying light pressure on radial or femoral arteries |
|
|
Term
|
Definition
| Greater than normal drop in systolic pressure during inhalation |
|
|
Term
|
Definition
3 factors that set stage for venous thrombosis
1. Venous stasis
2. Hypercoaguability
3. Vessel wall damage |
|
|
Term
|
Definition
| Edema is soft in early stages, then becomes hard and nonpitting. Skin is thickened, ulceration is rare, no pirgmentation and is usually found bilaterally on extremities. |
|
|
Term
| Why might the PMI be felt in the xiphoid process or epigastric area? |
|
Definition
| Results from right ventricular hypertrophy, usually as a result of obstructive pulmonary disease |
|
|
Term
| False high blood pressure |
|
Definition
Cuff too small
Cuff too loose or uneven
Arm below heart
Inflating or deflating too slow
Deflating cuff too quickly |
|
|
Term
|
Definition
Cuff too large
Repeating BP too quickly
Inaccurate level of inflation
Pressing stethoscope too tightly |
|
|
Term
|
Definition
- Normal <120, <80
- Prehypertension: S: 120-139, D: 80-89
- Stage 1: hypertension: S: 140-159, D: 90-99
- Stage 2: hypertension: S: 160+, D: 100+ |
|
|
Term
| How do we measure how swollen tonsils are? |
|
Definition
| Look inside mouth, measure from 1+(slightly swollen) to 4+ (swollen to tip of uvula) |
|
|
Term
| What are the auditory ossicles? |
|
Definition
| Composed of the malleus, incus, and stapes, it transmits vibration from the TM to the inner ear |
|
|
Term
| What is the eustachian tube and how does it differ in adults v. children? |
|
Definition
| It equalizes aie pressure form middle ear to nasopharynx and is more horizontal in child, more angled in adult |
|
|
Term
| What makes up the inner ear? |
|
Definition
Cochlea - converts vibrations and sends through cochlear nerve to the brain
Labyrinth - responsible for balance |
|
|
Term
| What are amblyopia, diplopia, myopia, hyperopia, and prebyopia? |
|
Definition
Amblyopia: lazy eye
Diplopia: double vision
Myopia: nearsightedness
Hyperpopia: farsighted
Presbyopia: decreased accommodation with aging |
|
|
Term
|
Definition
| A condition in which eyes make repetitive uncontrolled movements. It is normal at extremes of gaze but in Labyrinth disorder, it will be present after eye moves back to normal position |
|
|
Term
|
Definition
| A condition in which the eyes are not properly aligned with each other |
|
|
Term
| What are 3 types of primary headaches? |
|
Definition
1. Migraines
2. Tension
3. Cluster |
|
|
Term
| What are the processes of Migraines, Tension headaches, and cluster headaches? |
|
Definition
M: Primary neuronal dysfunction
T: Unclear-muscle contraction or vasoconstriction unlikely
C: Unclear-possibly extracranial vasodilation from neural dysfunction |
|
|
Term
| What are the different locations of Migraines, tension headaches, and cluster headaches? |
|
Definition
M: Usually unilateral
T: Usually bilateral; may be generalized or localized
C: Unilateral; usually behind or around eye |
|
|
Term
| What are the different qualities and their severities in migraines, tension headaches, and cluster headaches? |
|
Definition
M: Throbbing or aching, variable in severity
T: Pressing or tightening pain, mild to moderate intensity
C: Deep, continuous, severe |
|
|
Term
| Describe the Timing (onset, duration, course) for migraines, tension headaches, and cluster headaches. |
|
Definition
M: Onset is fairly rapid reaching peak in 1-2 hrs, lasts 4-72 hours and peak incidence is in early to mid adolescence, usually in women, usually monthly
T: Onset is gradual, lasts minutes to days, and is often recurrent or persistent over long periods
C: Onset is abrupt, peaks within minutes, lasts up to 3 hours, and is episodic, clustered in time with several each day for 4-8 wks, then relief for 6-12 mos. More common in men. |
|
|
Term
| What are the different associated factors for migraines, tension headaches, and cluster headaches? |
|
Definition
M: Nausea, vomiting, photophobia, phonophobia, visual auras, motor auras affecting hand or arm, sensory auras
T: Sometimes photophobia; phonophobia; nausea absent
C: Lacrimation, rhinorrhea, miosis, ptosis, eyelid edema, conjunctival infection |
|
|
Term
| What are the different aggravating/provoking factors for migraines, tension headaches, and cluster headaches? |
|
Definition
M: Alcohol, certain foods, or tension may provoke, more common premenstually, aggravated by noise/bright light
T: Sustained muscle tension, as in driving or typing
C: During attack, sensitivity to alcohol may increase |
|
|
Term
| What are the relieving factors for migaines, tension headaches, and cluster headaches? |
|
Definition
M: Quiet, dark room; sleep; sometimes transient relief from pressure on the involved artery, if early in the course
T: Possibly massage, relaxation
C: ? |
|
|
Term
| What type of headaches are sinusitis headaches and those related to meningitis? |
|
Definition
|
|
Term
| What are the different processes for headaches related to sinusitis and meningitis? |
|
Definition
S: Mucosal inflammation of the paranasal sinuses
M: Infection of the meninges surrounding the brain |
|
|
Term
| Where are the different locations common to headaches related to sinusitis and meningitis? |
|
Definition
S: Usually above the eye or over the maxillary sinus
M: Generalized |
|
|
Term
| Describe the quality and severity of headaches related to sinusitis and meningitis. |
|
Definition
S: Aching or throbbing; variable in severity; consider possible migraine
T: Steady or throbbing, very severe |
|
|
Term
| Describe the Timing (onset, duration, course) for headaches related to sinusitis and meningitis. |
|
Definition
S: Variable onset, often lasts several hours at a time, recurring over days or longer; often recurrent in a repetitive daily pattern
M: Fairly rapid onset, duration is variable, usually days; it is a persistent headache in an acute illness |
|
|
Term
| Describe the associated factors in the headaches related to sinusitis and meningitis. |
|
Definition
S: Local tenderness, nasal congestion, discharge, and fever
M: Fever, stiff neck |
|
|
Term
| Describe the aggravating/provoking factors in headaches related to sinusitis and meningitis. |
|
Definition
S: May be aggravated by coughing, sneezing, or jarring the head
M: none? |
|
|
Term
| Describe the factors that relieve headaches related to sinusitis and meningitis. |
|
Definition
S: Nasal decongestants, antibiotics
M: N/A? |
|
|
Term
|
Definition
| Increased adrenal cortisol production produces a round or "moon" face with red cheeks. Excessive hair growth may be present on face. |
|
|
Term
|
Definition
| Increased growth hormone produces enlargment of both bone and soft tissue. Head is elongated, with bony prominences fo the forehead, nose, and lower jaw. Facial features appear coarsened. |
|
|
Term
|
Definition
| Decreased facial mobility blunts expression. A masklike face may result with decreased blinking and a characteristic stare. Neck and upper trunk flex forward, facial skin becomes oily, and drooling may occur. |
|
|
Term
|
Definition
| The eyeball protrudes forward. When bilateral, can indicate infiltrative ophthalmopathy of Graves hyperthyroidism. Unilateral is seen in Graves disease or a tumor or inflammation of the orbit. |
|
|
Term
|
Definition
| Unequal pupils. When greater in bright light causes could include blunt trauma to eye, open-angle glaucoma, and impaired parasympathetic nerve supply to iris. When greater in dim light caused by interruption of sympathetic nerve supply. |
|
|
Term
|
Definition
| Produces recurrent and painful vesicular eruptions of the lips and surrounding skin. A small cluster of vesicles first develops. As these break, yellow-brown crusts form, and healing ensues within 10-14 days. |
|
|
Term
|
Definition
| A diffuse, nonpitting, tense swelling of the dermis and subcutaneous tissue. It develops rapidly, and typically disappears over subsequent hours or days. Although usually allergic in nature and sometimes associated with hives, it does not itch. |
|
|
Term
|
Definition
| These whitish raised areas with a feathery or corrugated pattern most often affect the sides of the tongue. Unlike candidiasis, these areas cannot be scraped off. They are seen in HIV and AIDS |
|
|
Term
| Name the physical borders for the anterior triangle of the neck |
|
Definition
1. Mandible above
2. Sternomastoid laterally
3. Midline of the neck medially |
|
|
Term
| What are the anatomical borders for the posterior triangle of the neck? |
|
Definition
1. Sternomastoid muscle
2. Trapezius muscle
3. The clavicle |
|
|
Term
| What does the thyroid feel like in Grave's Disease, Hashimoto Thyroidectomy, malignancy, and thyroiditis? |
|
Definition
| Soft in Grave's Disease; Firm in Hashimotos; Firm in malignancy; tenderness in thryroiditis |
|
|
Term
|
Definition
| Tests near vision and helps identify the need for reading glasses or bifocals in patients older than 45 |
|
|
Term
| What area of the male anatomy is a potential hernia site? |
|
Definition
| Juncture of lower abdomen wall and thigh is a potential hernia site in which a loop of bowel (colon) portrudes though a weak spot in musculature |
|
|
Term
| What do the lymphatics of the penis and scrotal surfaces drain into? |
|
Definition
|
|
Term
| What do the lymphatics of the testes drain into? |
|
Definition
| The abdominal lymph nodes (which aren't accessible to exam) |
|
|
Term
| What are the anatomical borders of the inguinal area? |
|
Definition
| The anterior superior iliac spine and symphysis pubis |
|
|
Term
| How long is the inguinal canal and what are the openings called? |
|
Definition
| 4-6 cm in an adult and the two openings are called the internal ring and the external ring |
|
|
Term
| List the Tanner scale stages of pubic hair |
|
Definition
Tanner I: no pubic hair at all
Tanner II: small amount of long down pubic hair with slight pigment
Tanner III: Hair becomes more coarse and curly
Tanner IV: adult-like hair quality, extending across pubis but sparing medial thighs
Tanner V: hair extends to medial surface of the thighs |
|
|
Term
| What should you do if you notice a mass during a scrotal examination? |
|
Definition
| Transilluminate it: By holding a light behind the scrotum one can easily determine whether the mass is cystic (light shines through) or solid (light blocked by the mass) |
|
|
Term
| What is the concern if abnormalities are noted in the epididymis and spermatic cord? |
|
Definition
|
|
Term
|
Definition
| Pathological accumulation of serous fluid in the scrotum. The main symptom is a painless swollen testicle which feels like water balloon |
|
|
Term
|
Definition
| Inflammation of the testes |
|
|
Term
|
Definition
| Abnormal location of the urethral opening |
|
|
Term
| What are the signs of testicular cancer? |
|
Definition
| unilateral, hard, painless mass |
|
|
Term
| During a prostate exam, what would be considered abnormal findings? |
|
Definition
-greater than 2.5cm
- irregular
-"boggy"/very mushy
-very hard
-tender |
|
|
Term
| Fecal Occult Blood Test (FOBT) |
|
Definition
| This at home test detects blood in the stool by placing a small sample of stool on a chemically treated card, pad, or wipe. Two separate BMs are tested since cancerous tumors can bleed intermittently. |
|
|
Term
How frequently should a patient get:
1. FOBT
2. Flex Sig
3. Colonoscopy |
|
Definition
1. Once a year (unless done in combo with Flex Sig, then every 3 years)
2. Every 5 years
3. Every 10 years |
|
|
Term
|
Definition
| Doctor looks for polyps/cancer in rectum and lower third of colon with a small, thin, lighted tube inserted into rectum. Pt. must take enema/laxative night before procedure |
|
|
Term
|
Definition
| Similar to flex sig, except the doctor uses longer lighted tube, checks for polyps/cancer in rectum and entire colon, and during test doctor can find and remove most polyps and some cancers. Pt. is slight sedated during test. |
|
|
Term
| A young man feels a sharp pain in his testicle. At what point does he go to a doctor? How long does he have before serious damage occurs? How much time is too long? |
|
Definition
1. If the pain lasts for more than one hour
2. If he does not see a doctor within 6 hours, chances that his testicle will have permanent damage rise
3. If he does not go to a doctor within 24 hours |
|
|
Term
| What is the most current US Preventative Services Task Force stance on prostate-specific antigen (PSA) based screening for prostate cancer? |
|
Definition
| It recommends against it, stating the potential benefit does not outweigh the risk. Only 1 out of 1000 men every 10 years are thought to be helped by PSA screeening, yet 120 out of every 1000 men receive a false-positive test, thereby leading to overdiagnoses and overtreatment. |
|
|
Term
| What does the prostate do? |
|
Definition
| Produces fluid that makes up a part of the semen |
|
|
Term
| How does the prostate change as men age? How does this relate to urination? |
|
Definition
| It enlarges and causes the urethra to narrow, thereby decreasing urine flow |
|
|
Term
| What are some of the symptoms of prostate cancer? |
|
Definition
-Difficulty starting urination
-Weak or interrupted urine flow
-Frequent urination, especially at night
-Difficulty emptying the bladder completely
-Pain or burning during urination or ejaculation
-Pain in the back, hips, or pelvis that doesn't resolve |
|
|
Term
| What are risk factors for prostate cancer? |
|
Definition
1. Age: the older the man, the higher the risk
2. Family History
3. Race: more common in African Americans |
|
|
Term
| What are symptoms of colon cancer? |
|
Definition
There may not be any, but if there are:
1. Blood in or on stool
2. Stomach pains, aches, or cramps that don't resolve
3. Unexplained weight loss |
|
|
Term
| What are the risk factors associated with colon cancer? |
|
Definition
1. Age: 90% cases occur in 50 yrs of age or older
2. Inflammatory Bowel Diseaes
3. Family History
4. Lifestyle Factors: low fiber/high fat intake, low physical activity; alcohol/tobacco use |
|
|
Term
| What is the best way to prevent colorectal (colon) cancer? |
|
Definition
| Screening. Precancerous polyps can be present in the colon for years before they turn into cancer, and we can find these polyps and destroy them before that during a screening. |
|
|
Term
| Who should be screened for cervical cancer and how often should screening be done? |
|
Definition
| Women 21 to 65 years old with Pap smear every 3 years; For women 30-65 who want to lengthen screening time, they can get a combination HPV test/Pap smear every 5 years |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Occurs when the wall between a woman's bladder and her vagina weakens and allows the bladder to droop into the vagina |
|
|
Term
|
Definition
| Occurs when the end of the large intestine (rectum) pushes through the back wall of the vagina |
|
|
Term
|
Definition
Gravida: total number of pregnancies
Para: total number of deliveries after 20 wks gestational age
Abortus: Number of pregnancy losses (elective, spontaneous before 20 weeks gest. age, induced) |
|
|
Term
| Concerning signs that may indicate breast cancer? |
|
Definition
-Signs of retraction
-Abnormal contours
-Skin dimpling
-Nipple retraction/deviation
-Edema of the skin
-Paget disease of the nipple |
|
|
Term
| Paget's disease of the nipple |
|
Definition
| Rare form of breast cancer in which the nipple and areola become scaly, red, itchy, and irritated |
|
|
Term
| What are the anatomical borders of the average female breast? |
|
Definition
| Extends from clavicle down to the 6th rib and from the sternum to the midaxillary line |
|
|
Term
| Which axillary lymph nodes are most palpable? |
|
Definition
|
|
Term
| What are the 3 most common kinds of breast masses? |
|
Definition
1. Fibroadenoma
2. Cysts
3. Breast Cancer |
|
|
Term
| What is the usual age for a woman to have a fibroadenoma, cyst, and breast cancer? |
|
Definition
F: 15-25; usually puberty and young adulthood, but up to 55
Cyst: 30-50, regress after menopause except with estrogen therapy
Cancer: 30-90; most common over age 50 |
|
|
Term
| What is the usual number of fibroadenomas, cysts, or cancerous lumps found at one time? |
|
Definition
F: Usually single, may be multiple
Cyst: Single or multiple
Cancer: Usually single |
|
|
Term
| What is the common shape of fibroadenomas, cysts, or cancerous masses found in the breast? |
|
Definition
F: Round, disc-like, or lobular
Cyst: Round
Cancer: Irregular or stelate |
|
|
Term
| What is the usual consistency of fibroadenoma, cyst, or cancerous mass found in the breast? |
|
Definition
F: May be soft, usually firm
Cyst: Soft to firm, usually elastic
Cancer: Firm or hard |
|
|
Term
| Of the 3 most common breast masses (fibroadenoma, cyst, and cancerous) which one is not clearly delineated upon examination? |
|
Definition
|
|
Term
| Of the 3 most common breast masses (fibroadenoma, cyst, and cancerous) which one is usually immobile and fixed to underlying tissues? |
|
Definition
|
|
Term
| Of the 3 most common breast masses (fibroadenoma, cyst, and cancerous) which one is often tender? |
|
Definition
|
|
Term
| Of the 3 most common breast masses (fibroadenoma, cyst, and cancerous) which one may show signs of retraction? |
|
Definition
|
|
Term
|
Definition
| pain or discomfort during intercourse |
|
|
Term
|
Definition
|
|
Term
| What are the 5 phases of a women's reproductive health? |
|
Definition
1. Prepuberty (premenstruation)
2. Puberty (menarche)
3. Childbearing (menstruation)
4. Perimenopausal
5. Menopausal |
|
|
Term
| What are the 3 types of hernias during reproductive examination? |
|
Definition
1. Indirect inguinal hernia (most common)
2. Direct inguinal hernia
3. Femoral hernia (more common in women) |
|
|
Term
| List the 3 abdominal quadrants. |
|
Definition
1. Epigastric
2. Umbilical
3. Hypogastric/Suprapubic |
|
|
Term
|
Definition
| bright red blood in stool |
|
|
Term
| What are the causes and symptoms of gastroenteritis? |
|
Definition
-Multiple causes such as: virus, bacteria, parasite, medications, food intolerances
-Symptoms include:
Nausea and/or vomiting
Diarrhea
Abdominal cramping
Fever |
|
|
Term
| What are abnormal bowel sound classifications? |
|
Definition
-Absent (obstruction): listen for full 4-5 min
-Hypoactive (decreased motility): Low gurgling <4 in 1 min
-Hyperactive (increased motility): High pitched, loud |
|
|
Term
|
Definition
-Push on LLQ then quickly remove hand
-Rebound tenderness in RLQ or pain in RLQ durring LLQ pressure (appendicitis) |
|
|
Term
|
Definition
| Pt. lays supine and examiner pushes down on patient's right thigh and asks pt. to raise leg. Pt. has pain in RLQ (appendicitis) |
|
|
Term
| Murphy's sign/Inspiratory arrest |
|
Definition
| Sharp pain upon inspiration when examiner's hand is palpating the liver (cholecystitis) |
|
|
Term
| What are classes physical findings of alcohol abuse? |
|
Definition
1. Hepatosplenomegaly (HSM)
2. Ascites
3. Caput medusa
4. Spider angiomas
5. Peripheral edema
6. Palmar erythema
7. Erythematic or bulbous nose |
|
|
Term
| What should you teach someone at risk for Hep A? |
|
Definition
-Transmission via fecal-oral
-Children often asymptomatic
-Vaccine available
-Prophylaxis: serum globulin
-Stess good handwashing techniques |
|
|
Term
| What are the 3 risk categories for Hep B? |
|
Definition
1. Sexual contacts
2. People with percutaneous or mucosal exposure to blood
3. Others: travelers, patients with chronic liver disease or HIV infection |
|
|
Term
| Who does the CDC recommend get Hep B vaccine? |
|
Definition
1. All adults in high-risk settings
2. In primary care or specialty settings
3. Adults in occupations involving exposure to blood or other potentially infectious body fluids
4. All pregnant women at first prenatal visit |
|
|
Term
| What are risk factors for Hep C? |
|
Definition
-Repeated percutaneous exposure
-IV drug users
-Transfusion with clotting factors before 1987
-Hemodialysis
-Sex partners using IV drugs
-Blood transfusion or organ transplant before 1992
-Occupational exposure
-Multiple or infected sex partner |
|
|
Term
| Risk factors for colorectal cancer |
|
Definition
-Past colorectal cancer or adenomatous polyp
-History of inflammatory bowel disease
-Family history of colorectal cancer or adenomatous polyp |
|
|
Term
| Peptic Ulcer and Dyspepsia process |
|
Definition
| Peptic ulcer refers to a demonstrable ulcer, usually in the duodenum or stomach. Dyspepsia causes similar symptoms but no ulceration. Infection by H. Pylori is often present. |
|
|
Term
| Peptic Ulcer and Dyspepsia (Location, quality, timing, aggravating factors, relieving factors, and associated symptoms and setting) |
|
Definition
L: Epigastric, may radiate to back
Q: Variable: gnawing, burning, pressing or hunger-like
T: Intermittent. Duodenal ulcer more likely to cause pain that 1) wakes at night, 2) occurs intermittently over a few weeks, then disappears for months, then recurs.
AF: Variable
RF: Food and antacids may bring relief
AS&S: N&V, Belching, bloating; Heartburn, weight loss. Dyspepsia is more common in the young (20-29), and gastric ulcer in those over 50, and duodenal ulcer in those 30-60. |
|
|
Term
| The processes of acute and chronic pancreatitis |
|
Definition
Acute: An acute inflammation of the pancreas
Chronic: Fibrosis of the pancreas secondary to recurrent inflammation |
|
|
Term
| Acute pancreatitis (Location, quality, timing, aggravating factors, relieving factors, and associated symptoms and setting) |
|
Definition
L: Epigastric, may radiate to the back or other parts of the abdomen; may be poorly localized
Q: Usually steady
T: Acute onset, persistent pain
AF: Lying supine
RF: Leaning foward with trunk flexed
AS&S: N&V, abdominal distention, fever. Often a history of previous attacks and alcohol abuse or gallstones. |
|
|
Term
| Chronic pancreatitis (Location, quality, timing, aggravating factors, relieving factors, and associated symptoms and setting) |
|
Definition
L: Epigastric, radiating through to the back
Q: Steady, deep
T: Chronic or recurrent course
AF: Alcohol, heavy or fatty meals
RF: Possibly leaning forward with trunk flexed; often intractable
AS&S: Symptoms of decreased pancreatic function may appear: diarrhea with fatty stools (steatorrhea) and diabetes mellitus |
|
|
Term
| Acute cholecystitis process |
|
Definition
| Inflammation of the gallbladder, usually from obstruction of the cystic duct by a gallstone |
|
|
Term
| Acute cholecystitis (Location, quality, timing, aggravating factors, relieving factors, and associated symptoms and setting) |
|
Definition
L: RUQ or upper abd; may radiate to the right scapular area
Q: Steady, aching
T: Gradual onset
AF: Jarring, deep breathing
AS&S: Anorexia, N&V, fever |
|
|
Term
| Acute diverticulitis process |
|
Definition
| Acute inflammation of a colonic diverticulum, a sac-like mucosal outpouching through the colonic muscle |
|
|
Term
| Acute diverticulitis (Location, quality, timing, aggravating factors, relieving factors, and associated symptoms and setting) |
|
Definition
L: LLQ
Q: May be cramping at first, but becomes steady
T: Often gradual onset
AS&S: Fever, constipation. There may be initial brief diarrhea. |
|
|
Term
|
Definition
| Acute inflammation of the appendix with distention or obstruction |
|
|
Term
| Acute appendicitis (Location, quality, timing, aggravating factors, relieving factors, and associated symptoms and setting) |
|
Definition
L: Poorly localized periumbilical pain, followed by RLQ pain
Q: Mild but increasing, possibly cramping; becomes steady and more severe
T: Lasts roughly 4-6 hours; then when it moves to RLQ it depends on intervention
AF: Movement or cough
RF: If it subsides temporarily, suspect perforation of the appendix
AS&S: Anorexia, nausea, possibly vomiting, which typically follows onset of pain, low fever |
|
|
Term
| Acute Mechanical Intestinal Obstruction process |
|
Definition
| Obstruction of the bowel lumen, most commonly caused by 1) adhesions or hernias (small bowel) or 2) cancer or diverticulitis (colon) |
|
|
Term
| Acute Mechanical Intestinal Obstruction (Location, quality, timing, aggravating factors, relieving factors, and associated symptoms and setting) |
|
Definition
L: Small bowel: periumbilical or upper abdominal; Colon: lower abdominal or generalized
Q: Cramping
T: Paroxysmal
AS&S: Small bowel: Vomiting of bile and mucus or fecal material. Obstipation develops; Colon: Obstipation early. Vomiting later ir at all. Prior symptoms of underlying cause. |
|
|
Term
| What are some problems that cause constipation? |
|
Definition
1. Lifestyle Activities and Habits
2. Irritable Bowel Syndrome
3. Mechanical Obstruction
4. Painful Anal Lesions
5. Drugs
6. Depression
7. Neurologic Disorders
8. Metabolic Conditions |
|
|
Term
| Acute diarrhea (2 processes) |
|
Definition
1. Secretory Infection: Infection by viruses, preformed bacterial toxins, cryptosporidium
2. Inflammatory Infection: Colonization or invasion of intestinal mucosa |
|
|
Term
| Acute Diarrhea: Secretory Infection (Characteristics of Stool, Timing, Associated Symptoms, Setting/Persons at Risk) |
|
Definition
CoS: Watery, without blood, pus, or mucus
T: Duration of a few days, possibly longer. Lactase deficiency may lead to a longer course.
AS: N&V, periumbilical cramping pain. Temperature normal or slightly elevated.
S/PaR: Often travel, a common food source, or an epidemic |
|
|
Term
| Acute Diarrhea: Inflammatory Infection (Characteristics of Stool, Timing, Associated Symptoms, Setting/Persons at Risk) |
|
Definition
CoS: Loose to watery, often with blood, pus, or mucus
T: An acute illness of varying duration
AS: Lower abdominal cramping pain and often rectal urgency, tenesmus; fever
S/PaR: Travel, contaminated food or water. Men and women who have had frequent anal intercourse |
|
|
Term
| What are the 6 components for a neurological physical examination? |
|
Definition
1. Mental Status: Cerebral Cortex
2. Cranial Nerves: Brainstem
3. Cerebellum and Motor system: Cerebellum, cerebral cortex, corticospinal and extrapyramidal tracts
4. Sensory system: Cerebral cortex, spinal cord/spinothalamic tract and posterior columns
5. Reflexes |
|
|
Term
| What are the two major divisions to the nervous system? |
|
Definition
1. Central Nervous system: brain and spinal cord
2. Peripheral Nervous system: 12 pairs cranial nerves and 31 pairs of spinal nerves |
|
|
Term
| What are the central components of the CNS? |
|
Definition
1. Brain and brainstem
2. Cerebellum
3. Spinal cord |
|
|
Term
| What are the 2 main functions of the peripheral nervous system? |
|
Definition
1. Somatic: skeletal muscles (voluntary movement)
2. Autonomic: smooth muscles (involuntary movement) |
|
|
Term
| List the 12 cranial nerves. |
|
Definition
CNI-Olfactory
CNII-Optic
CNIII-Oculomotor
CNIV-Trochlear
CNV-Trigeminal
CNVI-Abducens
CNVII-Facial
CNVIII-Acoustic
CNIX-Glossopharyngeal
CNX-Vagus
CNXI-Spinal-Accessory
CNXII-Hypoglossal |
|
|
Term
| What are the symptoms of expressive dysphagia? |
|
Definition
-Can understand what others are saying
-Words are slow and laborious, but meaningful
-Often gets frustrated |
|
|
Term
| What are the symptoms of receptive dysphagia? |
|
Definition
-Little or no comprehension of words
-Spoken words are fluent and nonsensical
-No idea the words and language are wrong |
|
|
Term
|
Definition
| A neurological scale that aims to give a reliable, objective way of recording the conscious state of a person. The score ranges between 3 (deeply unconscious) and 15 |
|
|
Term
| What part of the nervous system does each vital sign correlate to? |
|
Definition
HR = Vagus
Respiratory = Medulla, pons
BP=Medulla
Temp = Hypothalamus |
|
|
Term
| What would an abnormal finding during rapid rhythmic alternating movements be indicative of? |
|
Definition
| Possible cerebral disease . . . or drunk. Either one. |
|
|
Term
| What would an inability to walk straight be indicative of? |
|
Definition
| Cerebral Disease (MS) . . . or he's drunk. |
|
|
Term
|
Definition
Stand upright, place feet together, then close eyes for 20 sec
Positive test menas loss of balance - cerebellar disorder (MS, drunk) altered proprioreception |
|
|
Term
|
Definition
| Pt holds a "pizza box" at chest level - with supinated palms, close eyes and holds for 20 sec. Check for upper motor neuron disease - pronating indicates corticospinal lesion |
|
|
Term
| What would abnormal muscle tones indicate? |
|
Definition
-Flaccid: polio, Guillan-Barre
-Spastic: cerebral palsy, spinal cord injury
-Rigid: tetanus
-Cogwheel rigidity: parkinonism |
|
|
Term
|
Definition
| Familiar item in hand. If unable to ID, it means sensory cortex lesion |
|
|
Term
|
Definition
| "Write" number in palm and ID. If unable to ID, it indicates sensory cortex lesion |
|
|
Term
| 5 components needed for DTR response (IMPORTANT TO KNOW HINT HINT!) |
|
Definition
1. Intact sensory nerve (afferent)
2. A functional synapse in the cord
3. An intact motor nerve fiber (efferent)
4. Neuromuscular joint
5. A competent muscle |
|
|
Term
| Charting deep tendon reflexes |
|
Definition
| Rated from 0 (no response) and 4+ (very brisk - clonus present) |
|
|
Term
| If reflexes are hyperactice, what should you do? |
|
Definition
|
|
Term
| If assessing a comatose patient for deterioration, what should you do? |
|
Definition
| Check for Babinski response |
|
|
Term
| Order of the deterioration of LOC |
|
Definition
1. A&O alters
2. Lose ability obey simple commands
3. Then responses deteriorate from purposeless responses to pain
4. Then absence of response to pain
5. Then loss of corneal and gag reflexes |
|
|
Term
| What would cause sudden pupillary dilation and nonreactive pupil? |
|
Definition
| Pressure on the brainstem |
|
|
Term
|
Definition
| Involuntary extension of the upper extremities as a response to external stimuli |
|
|
Term
|
Definition
| Arms are flexed toward chest, fists are clenched, legs are extended, feet turned inward. A person decorticating in response to pain gets a 3 on the Glasgow Coma Scale |
|
|
Term
|
Definition
| Positive if hips and knees flex as you flex pt.'s neck, is meningeal sign |
|
|
Term
|
Definition
| Flex pt.'s leg at hip and knee, then try to straighten (neck adn back pain & resistance occurs). Positive Kernig's bilateral suggests meningeal irritation |
|
|
Term
| Transient Ischemic Attack (TIA) |
|
Definition
| Focal neurologic deficit lasting <1hr without underlying structural defects, highest risk of stroke within next 30 days |
|
|
Term
|
Definition
| Loss of voice that accompanies disease affecting the larynx or its nerve supply |
|
|
Term
|
Definition
| Refers to less severe impairment in the volume, quality, or pitch of the voice. For example, a person may be hoarse or only able to speak in a whisper. |
|
|
Term
|
Definition
| Refers to a defect in the muscular control of the speech apparatus. Words may be nasal, slurred, or indistinct, but central symbolic aspect of language remains intact. |
|
|
Term
|
Definition
| Refers to a disorders in producing or understanding language. It is often caused by lesions in the dominant cerebral hemisphere, usually the left. |
|
|
Term
|
Definition
| Start with focal manifestations. Divided into simple partial seizures, which do not impair consciousness, and complex partial seizures, which do. |
|
|
Term
|
Definition
| Begin with bilateral body movements, impairment of consciousness, or both. They suggest widespread, bilateral cortical disturbance that may be either hereditary or acquired. |
|
|
Term
|
Definition
| May mimic seizures but are due to a conversion reaction (a psychological disorder) |
|
|
Term
| Aortic stenosis and hypertrophic cardiomyopathy |
|
Definition
| Vascular resistance falls with exercise, but cardiac output cannot rise |
|
|
Term
|
Definition
| Refers to a lack of coordination of movement typified by the undershoot or overshoot of intended position with the hand |
|
|
Term
| What is often the first sense lost in peripheral neuropathy? |
|
Definition
|
|
Term
|
Definition
| Responsible for hearing, taste, and smell |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Numbness, tingling, burning, crawling |
|
|
Term
|
Definition
Dysphasia: Partial or complete impairment of the ability to communicate resulting from a brain injury
Dysphagia: difficulty swallowing |
|
|
Term
|
Definition
| "Muscle twitch" Small local involuntary muscle contraction and relaxatoin |
|
|
Term
| Acute care neuro assessment (Glasgow coma) |
|
Definition
-LOC
-Motor function
-Pupillary response
-Vital sets
-Add score for each thing, gives you an objective level of deterioration
-If you want neuro checks q15, this is what you would do |
|
|
Term
|
Definition
L1 or below: paraplegic
T6 and below: paraplegic
C6 and above: tetraplegia
C4 and above: tetraplegia, ventilator |
|
|
Term
|
Definition
| Difficult to arouse (loud noise, vigorous shaking or pain), sleeps most of the time, speech affected |
|
|
Term
|
Definition
| Need persistent, loud noise or pain for arousal, may respond to stimuli with a groan |
|
|
