Term
|
Definition
|
|
Term
| Infants develop control of their external anal sphincter by _______ |
|
Definition
|
|
Term
|
Definition
| Possible ulcerative colitis |
|
|
Term
| Cancers related to colorectal |
|
Definition
| Breast, ovarian, endometrial |
|
|
Term
| Leading cancer diagnosed in men |
|
Definition
|
|
Term
| 3 risk factors for prostate cancer |
|
Definition
Age (old), ethnicity (AA), family history
Also, high fat diet |
|
|
Term
| When to start PSA testing |
|
Definition
| Age 50, or age 40 if AA or family hx |
|
|
Term
|
Definition
| May indicate cyst or sinus |
|
|
Term
|
Definition
|
|
Term
|
Definition
Decreased flow
Possibly painful urination
Enlarged, boggy prostate |
|
|
Term
| Prostate cancer description |
|
Definition
Probable PSA
Firm, hard nodules |
|
|
Term
|
Definition
Likely in older adults
Possible slightly elevated PSA |
|
|
Term
Age groups:
Infancy
Early Childhood
Middle Childhood
Adolescence |
|
Definition
|
|
Term
| Most rapid growth occurs during _________ |
|
Definition
Infancy, year 1
Triple birth weight, increase height by 50% |
|
|
Term
|
Definition
Immediately after birth
Based on HR, RR, Muscle tone, reflexes and skin color |
|
|
Term
| Measuring height of children |
|
Definition
Length/height <2 years supine, >2 years standing
ALSO, measure head circumference until age 2
No BP in children <3 |
|
|
Term
|
Definition
Birth ~140 bpm
2-6 yrs ~100bpm
>10 yrs ~85bpm |
|
|
Term
|
Definition
Newborn 30-60
Early childhood 20-40
Late childhood 15-25
Puberty and up 12-20 |
|
|
Term
|
Definition
| Fine downy hair, gone after 2 weeks age |
|
|
Term
|
Definition
| white/yellow cheesy material in skin folds, left over sebaceous cells |
|
|
Term
|
Definition
| Most often in post term babies |
|
|
Term
|
Definition
Blue hands/feet
NORMAL in first few weeks
Mouth/tongue/face blue is NOT normal sign of cardiac disease |
|
|
Term
|
Definition
Kind of salmon patch, capillary malformation
Not pathologic |
|
|
Term
|
Definition
| Not pathologic, capillary malformations |
|
|
Term
| 6 or more cafe-au-lait spots |
|
Definition
| Sign of neuro-fibromatosis |
|
|
Term
|
Definition
Benign
B-blockers if needed, AVOID steroids/surgery |
|
|
Term
|
Definition
| Superficial inclusion cysts |
|
|
Term
|
Definition
| can use steroids, usually from blankets |
|
|
Term
|
Definition
|
|
Term
|
Definition
Baby oil and scrape it off
Avoid scented baby things |
|
|
Term
|
Definition
| Goes away without the color changing progression of a bruise |
|
|
Term
|
Definition
Can be candida or contact
Candida may show satellite regions, contact is more continuous |
|
|
Term
| Baby skull sutures usually close by _________ |
|
Definition
|
|
Term
|
Definition
Does not cross central suture line
Rupture of bridging vessels of periosteum |
|
|
Term
|
Definition
|
|
Term
|
Definition
May cause problems in sitting/standing/crawling
Pt needs to stretch out muscle in neck |
|
|
Term
| Strabismus abnormal after __________ |
|
Definition
|
|
Term
| Retinal hemorrhages in babies are indicative of |
|
Definition
|
|
Term
|
Definition
| Bluish discoloration to sclera |
|
|
Term
|
Definition
Retinoblastoma
Cogenital cataracts also possible |
|
|
Term
| Assessing hearing in babies |
|
Definition
Acoustic blink reflex- should blink when you snap your fingers
Will turn head towards sound by 3-4 months |
|
|
Term
| Breathing patterns in children |
|
Definition
| May be abnormal, up to 10-12 seconds of stopped breathing |
|
|
Term
|
Definition
Narrowing of aorta where the ductus arteriosus inserts
Take pulse above and below the diaphragm |
|
|
Term
|
Definition
| Breast enlargement and lactation from baby, usually from estrogen in mom- goes away |
|
|
Term
| 1st sign of puberty in girls |
|
Definition
|
|
Term
| Tanner staging for breasts |
|
Definition
1- preadolescent, nipple elevation
2- breast bud
3- elargement of areola and breast
4- secondary mound in areola and nipple
5- mature, areola recedes and nipple projects |
|
|
Term
|
Definition
| Usually closes by 1 yr old, otherwise needs surgery |
|
|
Term
|
Definition
Undescended testicles
Associated with testicular cancer |
|
|
Term
|
Definition
|
|
Term
|
Definition
1- preadolescent
2- slight enlargement
3- further enlarged
4- developed glans, darker scrotal skin
5- adult size |
|
|
Term
| Tanner staging- female pubic hair |
|
Definition
1- vellus
2- several slightly curly and pigment hairs
3- darker, coarser
4- coarse and curly
5- on thighs |
|
|
Term
| Barlow and Ortolani tests |
|
Definition
Hip displacement in babies
Hear/feel a clunk as femur pushes back into place |
|
|
Term
| Babinski normal up to ________ |
|
Definition
|
|
Term
|
Definition
Babinski- up until 2 years
Grasp- up until 3/4 months
Moro- 3/4 months
Tonic neck- up to 6 months
Rooting- 3/4 months
Placing and stepping- couple months |
|
|
Term
|
Definition
| Arm extends, opposite leg flexes |
|
|
Term
| corpora cavernosa/spongiosum |
|
Definition
| Cavernosa surrounds the spongiosum |
|
|
Term
| Testicles must descend by _________ |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Can typically protrude all the way into the scrotum |
|
|
Term
|
Definition
| Come out the external inguinal ring, dont go into scrotum |
|
|
Term
|
Definition
| Next to the femoral vein, more common in women |
|
|
Term
|
Definition
| Foreskin stuck Down (phi) and up (paraphi) |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Enlarged inguinal lymph nodes |
|
|
Term
|
Definition
| Painful erection, nodule in shaft |
|
|
Term
|
Definition
| Fluid in the tunica vaginalis |
|
|
Term
|
Definition
| swelling of the epididymis, may also transilluminate |
|
|
Term
|
Definition
| Bag of worms, seen when standing |
|
|
Term
| Orchitis associated with __________ |
|
Definition
|
|
Term
| Epididymitis presentation |
|
Definition
Tender/swollen epididymis
Systemic symptoms
Pain improved by elevating testes
Usually from STD in young men, E.Coli in pts over 40 |
|
|
Term
Sudden onset of severe pain in scrotum, discoloration
Usually adolescents |
|
Definition
|
|
Term
|
Definition
| Small, nondeveloped testes |
|
|
Term
| Levels of Attention: Alert, lethargic, obtunded, stuporous, coma |
|
Definition
Alert- awake/aware
Lethargic- requires forceful manner, loud voice
Obtunded- must be shaken for response
Stuporous- unarousable except by pain
Coma- Completely unarousable |
|
|
Term
|
Definition
| Awareness that thought, sx, or behaviors are normal/abnormal |
|
|
Term
|
Definition
| observable mood, facial expression, body movement and voice |
|
|
Term
|
Definition
Sustained emotion of the patient
Euthymic, manic, dysthymic |
|
|
Term
|
Definition
| Words/phrases substituted for a word the person cant remember (an eraser = that thing you block out your writing with) |
|
|
Term
|
Definition
| Words are malformed or invented (I write with a den. OR I write with a dar) |
|
|
Term
|
Definition
Speech with inderection or delay
Excessive details with no connection to the point |
|
|
Term
|
Definition
| Shift topics with no apparent relation |
|
|
Term
|
Definition
| Accelerated derailment. Change of topics in a fast but generally coherent manner |
|
|
Term
|
Definition
Invented/distorted words
Kind of like paraphasias |
|
|
Term
|
Definition
| Incomprehensible because its illogical |
|
|
Term
|
Definition
Sudden interrupted speech
"Brain farts" occur in normal people |
|
|
Term
|
Definition
| Fabrication to hide memory impairment |
|
|
Term
|
Definition
| Persistent repetition of words/ideas |
|
|
Term
|
Definition
| Repetition of words/phrases |
|
|
Term
|
Definition
| Choosing words based on their sound rather than meaning |
|
|
Term
|
Definition
| Fixed, false belief not shared by others in your culture |
|
|
Term
|
Definition
Misinterpretation of real stimuli
Towel can be ghost
Postman leaving mail can be a plot to poison you |
|
|
Term
|
Definition
Subjective external stimuli
Hear/see things others don't
May or may not recognize them as being false
EX) abe lincoln on penny can speak |
|
|
Term
|
Definition
| Digital span, serial 7s, spelling backwards |
|
|
Term
|
Definition
| Have them copy a geometric figure or draw a clock |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
For coma
15 is optimal, <8 is a coma |
|
|
Term
|
Definition
Sudden onset, worse at night (Sunsetting)
Loss of memory, consciousness
Tremors and movements
Rapid mood swings
Delusions or hallucinations
Can be reversed |
|
|
Term
|
Definition
Alcohol withdrawal
Elevated vitals, anxiety, restlessness
45-72 hrs after last alcohol consumed |
|
|
Term
|
Definition
Insidious, relentless or sporadic onset
Permanent, non-reversible
Mood becomes depressed, apathetic
Delusions, no hallucinations |
|
|
Term
|
Definition
Temporary from brain injury
Dizziness, dazed look
Irritable
N/v
Amnesia, deficits in coordination |
|
|
Term
| Vascular (malti-infarct) dementia |
|
Definition
| Rapid onset, associated with CVA |
|
|
Term
| Broca's area (function and location) |
|
Definition
Used for speech
R.handed- left side
L.handed- 50/50 left/right |
|
|
Term
| Spinal cord extends from _______ to ______ |
|
Definition
| brainstem to L1/L2 vertebrae |
|
|
Term
| 5 segments of the spinal cord |
|
Definition
Cervical (C1-8)
Thoracic (T1-12)
Lumbar (L1-5)
Sacral (S1-5)
Coccygeal (1) |
|
|
Term
| How many peripheral nerves? |
|
Definition
31! 8 12 5 5 1
From each of the spinal nerves, commingle with similar fibers |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Dermatome: Thumb and radial portion of arm |
|
Definition
|
|
Term
| Dermatome: Pinky and ulnar portion of arm |
|
Definition
|
|
Term
| Dermatome: Quads and front of knee |
|
Definition
|
|
Term
| Dermatome: Shin and dorsal aspect of foot |
|
Definition
|
|
Term
| Damage at the spinal level results in: |
|
Definition
Pain/temperature loss on the opposite side
Fine touch/vibration loss on the same side |
|
|
Term
|
Definition
worse as the day progresses, stress
Steady and band-like |
|
|
Term
|
Definition
More in men, unilateral, rhinorrhea, tearing in eyes
knifelike |
|
|
Term
|
Definition
Women, throbbing, unilateral, sometimes an aura
Classic- flashing lights and prodrome
Common- without prodrome |
|
|
Term
|
Definition
0- no contraction detected
2- gravity eliminated
3- against gravity
5- full movement against resistance |
|
|
Term
|
Definition
Rapid alternating movements
Point to point
Gait |
|
|
Term
| Romberg test and pronator drift |
|
Definition
| posterior column problems |
|
|
Term
|
Definition
Usually 0 to 4+
2+ is average; normal
4+ is clonus
0 is no response |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Brachioradialis/supinator reflex |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Plantar reflex (babinski) |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
Common with stroke!
Can understand, cant get the words out
Fluency not there, comprehension is |
|
|
Term
|
Definition
Cant understand, can speak fluently
Fluency is there but comprehension isn't |
|
|
Term
|
Definition
| Combo of broca and wernicke, no comprehension or fluency |
|
|
Term
|
Definition
Usually L4-L5 or L5-S1 distribution
Straight leg raise test |
|
|
Term
|
Definition
Demylenating, idiopathic
Weakness, numbness, unsteadiness |
|
|
Term
|
Definition
|
|
Term
|
Definition
sudden blindness for 30-60 min from embolism that blocks retinal circulation
Possible during TIA |
|
|
Term
|
Definition
incoherrent thought or speech
Possibly from TIA |
|
|
Term
|
Definition
HTN is a predisposition
Internal capsule
Pure MOTOR hemiplegia |
|
|
Term
| Middle cerebral artery syndrome |
|
Definition
Hemiparesis (Face and arm, some leg)
Sensory loss
Homonymouse hemianopsia
Eye deviation to the side of the lesion |
|
|
Term
| Anterior cerebral artery syndrome |
|
Definition
Paralysis of lower leg
Incontinence |
|
|
Term
|
Definition
RIND lasts up to 24hrs
Lupus is at risk for TIA
amaurosis fugax, transient aphasia, slurred speech, syncope, dizziness, numbness... |
|
|
Term
| Posterior cerebral artery syndrome |
|
Definition
Homonymous hemianopsia often the only finding
Be able to distinguish between middle cerebral artery |
|
|
Term
|
Definition
Ipsilateral to lesion- facial numbness
Horner's syndrome
Pain over eye
Contralateral to lesion- pinprick and temp loss to arm/leg
Vertigo, hoarsness, diplopia |
|
|
Term
| Anterior spinal artery syndrome |
|
Definition
ALL motor and most sensory lost, position preserved
Cervical spinal injury |
|
|
Term
|
Definition
Loss of motor and position on same side
Pain and sensation on opposite side
Cervical spinal injury |
|
|
Term
| Posterior Column Syndrome |
|
Definition
Only position sense lost on ipsilateral side
Cervical spine injury |
|
|
Term
|
Definition
Autoimmune decreased acetycholine
Muscle weakness, diplopia, ptosis |
|
|
Term
|
Definition
Proximal muscle weakness
Ends in respiratory depression |
|
|
Term
|
Definition
| Pain in trigeminal distribution |
|
|
Term
|
Definition
| Stocking glove distribution or peripheral nerve |
|
|
Term
|
Definition
Unable to wrinkle forehead
May be from trauma, infectious lyme etc |
|
|
Term
|
Definition
|
|
Term
|
Definition
Loss of dopaminergic neurons in substantia nigra
Cog wheel rigidity
Loss of ability to initiate movement |
|
|
Term
|
Definition
| Memory, language, mood impairment |
|
|
Term
|
Definition
Few WBC
Clear fluid
Somewhat viscous
Effusions may become less viscous, more yellow with infection |
|
|
Term
| Athrocentesis glucose measure |
|
Definition
| Drops with infectious cause |
|
|
Term
| Joint infection from non-direct penetration |
|
Definition
|
|
Term
| Monosodium urate monohydrate crystals in synovium |
|
Definition
|
|
Term
| Calcium pyrophosphate dihydrate crystals in synovium |
|
Definition
|
|
Term
| Calcium phosphate (hydroxyapatite) crystals in synovium |
|
Definition
| Inflammatory osteoarthritis |
|
|
Term
| Calcium Oxalate crystals in synovium |
|
Definition
|
|
Term
| Cholesterol in joint synovium |
|
Definition
|
|
Term
|
Definition
Add acetic acid- normal is firm white clot
Abnormal becomes cloudy
Tests for inflammatory joint disease |
|
|
Term
|
Definition
| Increase with active disease |
|
|
Term
| Complement levels (Look for C3) |
|
Definition
| Go down with active rheumatologic disease |
|
|
Term
|
Definition
| Rheumatic fever, look for 4fold increase |
|
|
Term
|
Definition
|
|
Term
|
Definition
Screening test for Rheumatologic Dz
Sensitive but not specific for SLE |
|
|
Term
|
Definition
CREST syndrome
Specific and sensitive |
|
|
Term
| Anti-double stranded DNA antibody |
|
Definition
| Specific for SLE (not sensitive) |
|
|
Term
|
Definition
| Specific for SLE (not sensitive) |
|
|
Term
| Anti-ribonucleoprotein (RNP) |
|
Definition
| Sensitive for Mixed connective tissue disease, not specific |
|
|
Term
|
Definition
For rheumatoid arthritis
Not specific |
|
|
Term
| Anti cyclic citrulinated peptide (CCP) |
|
Definition
|
|
Term
|
Definition
scleroderma
Specific but not sensitive |
|
|
Term
|
Definition
Sjrogrens
Not too sensitive or specific |
|
|
Term
| Antineutrophil cytoplasmic test |
|
Definition
| High specificity for Wegners granulomatosis |
|
|
Term
|
Definition
SITS
Supra/infraspinatus
Teres minor
Subscapularis |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Chronic shoulder dislocation |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Impingement of supraspinatous tendon |
|
|
Term
|
Definition
Throacic outlet syndrome
Compression of subclavian artery or vein and brachial plexus |
|
|
Term
| Mid deltoid sensation is pure ___________ nerve |
|
Definition
|
|
Term
| Serratus anterior muscle innervated by ____________ |
|
Definition
|
|
Term
| How many Carpals? metacarpals? phalanges? |
|
Definition
8 carpal bones (wrist)
5 metacarpals (hand bones)
5 phalanges (fingers) |
|
|
Term
| Median nerve innervates which digits? |
|
Definition
|
|
Term
| Herberden's and bouchards nodes |
|
Definition
DIPJ and PIPJ respectively
OA |
|
|
Term
| Pain in the anatomic snuff box |
|
Definition
|
|
Term
| Swan neck and boutonniere deformities |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Flick, Tinnel, Phalan signs |
|
Definition
|
|
Term
|
Definition
24
7, 12 and 5
24 hrs in a day, you eat at 7, 12 and 5 |
|
|
Term
| Iliac crest is at the level of vertebrae _________ |
|
Definition
|
|
Term
| Malingering test for lower back pain |
|
Definition
|
|
Term
| When measured, a broken hip will be _________ and ________ |
|
Definition
| shortened and externally rotated |
|
|
Term
|
Definition
|
|
Term
|
Definition
Lateral femoral condyle to medial tibia
Prevent tibia from sliding forward
Test with anterior drawer test |
|
|
Term
|
Definition
Lateral tibia to medial femoral condyle
Prevent tibia from sliding backwards
Test with posterior drawer test |
|
|
Term
|
Definition
Valgus = Knock knee
Varus = bowlegged |
|
|
Term
|
Definition
McMurry for medial and lateral
Apley to distinguish from tendon injury |
|
|
Term
|
Definition
Anterior talofibular ligament
Test with anterior draw sign of ankle |
|
|
Term
|
Definition
|
|
Term
| ADH (antidiuretic hormone) |
|
Definition
Small cell lung cancer
Adenocarcinoma |
|
|
Term
|
Definition
Liver cancer
germ cell cancer of ovaries or testis |
|
|
Term
| BTA (Bladder tumor antigen) |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Carcinoembryonic antigen (CEA) |
|
Definition
Colon cancer
Also elevated in smoking |
|
|
Term
| Lactic dehydrogenase (LDH) |
|
Definition
| Lymphoma, seminoma, acute leukemia, metastatic cancer |
|
|
Term
| PSA (prostate specific antigen) |
|
Definition
prostate cancer
False positive with BPH |
|
|
Term
| Caffeine and smoking with BP |
|
Definition
Avoid 30 min prior
(30 is also the number mmHg added to palpated BP) |
|
|
Term
|
Definition
Systolic drops >20mmHg or Diastolic drops >10mmHg
Pulse changes by 20 bpm
(Pulse change more frequently seen in young pts, BP and pulse in older) |
|
|
Term
|
Definition
| Heart points R instead of L |
|
|
Term
|
Definition
Low pitched, maybe better with bell
May indicate heart failure
Dilated chambers cause extra sound
Best heard over apex (mitral area) |
|
|
Term
|
Definition
Shrinks
Ventricular walls thicken
Valves fibrose
Less elastic |
|
|
Term
| Fist over chest, waxing/waning pain, heavy |
|
Definition
|
|
Term
| Cardiac presentation in children |
|
Definition
| Cyanosis, SOB, tiring durin gplay and feeding |
|
|
Term
|
Definition
At 30degrees, up to 4 cm is normal
Valsalva may help expose JVD
JVP is measured from heart level (nl=9cm) |
|
|
Term
| Location of apical impulse |
|
Definition
| 4th/5th intercostal, mid clavicular, 7-9cm lateral from midsternum, less than 2.cm diameter |
|
|
Term
|
Definition
Thrill- fine, palpable
Heave- elevation in chest wall (usually R sided problem) |
|
|
Term
|
Definition
| Aortic, pulmonic, second pulmonic (erbs point), tricuspid, mitral |
|
|
Term
|
Definition
Heard over pulmonic area
Leaning forward |
|
|
Term
| Ejection click most commonly heard ___________ |
|
Definition
|
|
Term
|
Definition
1-6 intensity
Pattern (crescendo, decrescendo)
Quality (harsh, blowing)
Location/radiation
Pitch
timing |
|
|
Term
|
Definition
1- barely audible
4- loud with a thrill
5- heard with stethoscope partially off chest
6- visibile thrill, stethoscope completely off chest wall |
|
|
Term
| After releasing the valsalva... |
|
Definition
| R sided events return in 1-3 beats, L sided events in 4-11 |
|
|
Term
| Valsalva, exercise, expiration, hand grip effects on murmurs |
|
Definition
Valsalva decreases
Exercise increase
Expiration increases (brings heart closer to chest wall)
Hand grip increases L sided regurgitation, decreases L sided ejection |
|
|
Term
| Aortic stenosis heard mainly in |
|
Definition
|
|
Term
| Hypertrophic cardiomyopathy mainly heard in |
|
Definition
|
|
Term
|
Definition
| Dizziness, fainting, chest pain, patterns of fast and slow heart beats |
|
|
Term
|
Definition
| New onset murmur near bacterial growth |
|
|
Term
|
Definition
|
|
Term
| Normal fasting glucose level |
|
Definition
|
|
Term
| Impaired fasting glucose level |
|
Definition
| 100-124mg/dL on more than 1 occasion |
|
|
Term
|
Definition
8-12 hr fast
Normal glucose <140 mg/dL 2hr after glucose load
Impaired is 140-199
Diabetes is >200 mg/dL |
|
|
Term
| DM HgA1C, Fasting glucose, OGTT, random |
|
Definition
6.5%
126 fasting
200 OGTT after 2 hrs
200 at any random time |
|
|
Term
| Increased risk for DM: A1C, fasting, OGTT |
|
Definition
| A1C 5.7 to 6.4%, fasting 100 to 125, and OGTT between 140 and 199 |
|
|
Term
|
Definition
| Endogenous insulin production |
|
|
Term
| Beta-hydroxybutyric acid, acetone |
|
Definition
| present in DKA with an increased anion gap |
|
|
Term
Goal for pts with Diabetes:
HgA1C
FBS
Microalbuminuria
LDL |
|
Definition
HgA1C less than 7
FBS between 70 and 130
Microalbumin/creat ratio <30 mcg/mg
LDL <100 |
|
|
Term
| Lab findings in a hypothyroid patient |
|
Definition
Increased TSH
Decreased T3 and T4
Thyroglobulin studies to determine cause |
|
|
Term
| Lab findings in Hyperthyroidism |
|
Definition
Very low TSH
Increased T4 and T3
Increased TPO (integrates iodine into thyroid hormone) |
|
|
Term
|
Definition
| exopthalmoses, enlarged boggy prostate, +TRab |
|
|
Term
|
Definition
| Tender, thyroid antibodies, decreased iodine uptake |
|
|
Term
|
Definition
Corrected for albumin
or use Ionized calcium |
|
|
Term
| Total cholesterol numbers |
|
Definition
Desirable <200 mg/dL
Borderline 200-239 mg/dL
High risk >240 mg/dL |
|
|
Term
|
Definition
High risk <40 mg/dL
Low risk or protective > 60 mg/dL |
|
|
Term
|
Definition
Goal <150 mg/dL
>500 rf for pancreatitis
>1000 rf for CAD |
|
|
Term
|
Definition
Optimal <100mg/dl
<70mg/dL in high risk groups (DM) |
|
|
Term
|
Definition
LDL = Total cholesterol - HDL - (Trig/5)
Unless trig over 400 |
|
|
Term
| When is prolactin level ordered? |
|
Definition
| Workup of amenorrhea or galactorrhea (<20ng/mL is normal) |
|
|
Term
| FSH is ordered to _________ |
|
Definition
| workup amenorrhea and infertility |
|
|
Term
| Testosterone measured in________________ |
|
Definition
Males that complain of sexual dysfunction (LOW)
Women with amenorrhea/pCOS (HIGH) |
|
|
Term
| Estradiol is ordered to _______________ |
|
Definition
| See if pt is post menopause (decreases with menopause and pregnancy) |
|
|
Term
| 17 hydrodoxyprogesterone is measured in __________ |
|
Definition
workup of virilization and hirsutism
Diagnosis of Cogenital Adrenal Hyperplasia |
|
|
Term
|
Definition
Elevated in hyperprolactinemia, adrenal hyperplasia, adrenal tumor, PCOS
Produced EXCLUSIVELY in the adrenal gland |
|
|
Term
|
Definition
Central obesity, moon face, buffalo hump, HTN, DM, abdominal striae
Excessive cortisol from the adrenal gland |
|
|
Term
| Cortisol level throughout the day |
|
Definition
Highest at 8am, early morning
Fluctuate with stress, depression, alcoholism etc. |
|
|
Term
| Dexamethasone suppression test |
|
Definition
Sugar should inhibit cortisol, so:
Low dose=
Cortisol is supressed <5 in normal pt, >10 cushings syndrome
High dose=
Cortisol <5 for pituitary adenoma, >5 is ectopic ACTH |
|
|
Term
|
Definition
Syndrome = primary adrenocortical excess
Dz = Secondary excess, or ectopic site |
|
|
Term
|
Definition
Severe HTN on mulitple medications
Hypokalemia |
|
|
Term
| Geriatrics: BP, HR, Temp reg, Skin, Hearing, Salivation |
|
Definition
BP- risk for orthostatic HTN
General HTN
Pacemaker cells decline
Cant tolerate cold as well, sometimes heat too
Skin becomes thin, lose hair
Presbycusis- lose hearing
Difficulty hearing Higher tones
Decreased salivation |
|
|
Term
| Palpable ovaries 10 years post menopause |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Changes with pregnancy: Breasts, skin, thyroid, muscles |
|
Definition
Breast- enlarged, tender
Skin- melanoma over skin and nose, striae
Thyroid- enlargement
Muscles- laxity
Will also have lower BP, weight gain/loss, hair changes, nasal congestion, diastolic murmurs, bleeding gums... |
|
|
Term
|
Definition
| Softening of isthmus of uterus |
|
|
Term
|
Definition
|
|
Term
| Review Gravidity and Parity |
|
Definition
| Gravidity is pregnancies, parity is births |
|
|
Term
| Estimated gestational age |
|
Definition
|
|
Term
|
Definition
| add 7 days, subtract 3 months from LMP |
|
|
Term
| Diet/exercise for pregnant women |
|
Definition
Only need 200-300 more calories
500 for nursing
Can continue to exercise, careful of balance |
|
|
Term
|
Definition
| Appears on pregnant women |
|
|
Term
|
Definition
| Measurement of pregger's belly, estimates +/-2 weeks accurately |
|
|
Term
|
Definition
To establish positioning of baby
Should have baby's head towards vaginal canal |
|
|
Term
| Superficial veins of the legs |
|
Definition
Great/small saphenous
Anastomotic veins- connect the saphenous
Perforating veins- connect superficial with deep |
|
|
Term
| Concerning symptoms in legs |
|
Definition
Intermittent claudication
Hair loss
Swelling (usually venous problem) |
|
|
Term
| Peripheral arterial disease (PAD) |
|
Definition
TRIAD of Intermittent claudication
Exercise induced, stops after exercise |
|
|
Term
|
Definition
| Finger or toe color changes |
|
|
Term
|
Definition
| Screen men over 65 and smokers |
|
|
Term
|
Definition
3+ bounding
2+ brisk (normal)
1+ diminished
0 absent |
|
|
Term
|
Definition
heart failure
Check 2 locations |
|
|
Term
|
Definition
| Pitting edema with SOB, nocturnal dyspnea, orthopnea, b/l rales, s3 or s4 |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Assess retrograde filling while holding great saphaneous vein in leg |
|
|
Term
|
Definition
| Varicose vein testing with a tourniquet |
|
|
Term
| Chronic arterial insufficiency |
|
Definition
Pt is supine, raise both feet until pallor occurs
Ask pt to dangle feet quickly
Normal color returns in less than 10, veins fill in 15 |
|
|
Term
| ABI (Ankle-brachial index) |
|
Definition
Use doppler to measure systolic BP in ankle
Lower extremity/upper extremity
<0.9 is mild to moderate disease
<0.5 is worrisome (means pressure in leg is less than half that in the arms) |
|
|
Term
| Cranial arteritis (giant cell arteritis) |
|
Definition
| Over age 50, TENDER temporal artery |
|
|
Term
|
Definition
r/f HTN, smoking, infections
May be large aneurysm or dissection |
|
|
Term
|
Definition
A.fib or flutter that causes a clot in the atrium
May blow out and cause multiple embolisms |
|
|
Term
| Sx of arterial insufficiency |
|
Definition
| claudication, decreased pulse, bruits, loss of body warmth, atrophied hair or skin... |
|
|
Term
|
Definition
| Pain, pallor, puleselessness, paresthesia, paralysis, poikilothermia |
|
|
Term
|
Definition
| Probably unilateral, possible palpable cord |
|
|
Term
|
Definition
| Hyperpigmentation, lateral maleolus ulceration, thickened skin |
|
|
Term
| Know the female genitalia- |
|
Definition
| Mons pubis, prepuce, urethral meatus, perineum, introitus, labium majus/minus |
|
|
Term
| Bartholin and skene glands |
|
Definition
| Skene are up by the urethrea, bartholin by the butt |
|
|
Term
|
Definition
Most are anteverted
May be retroverted (facing a little farther dorsal) or retroflexed (flexed very dorsally, may be palpable through rectum) |
|
|
Term
|
Definition
Portion of cervix thats visible
Squamous epithelium |
|
|
Term
|
Definition
| Slit-like opening of cervix |
|
|
Term
|
Definition
| contains columnar epithelium |
|
|
Term
|
Definition
| small, round, oval (never had a child) |
|
|
Term
|
Definition
| Slit-like, after childbirth |
|
|
Term
|
Definition
| Internal anatomy of femal, ovaries and fallopian tubes |
|
|
Term
|
Definition
Produce ova
Produce estrogen/progesterone/testosterone |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Average periods: how long? how often? how many pads? |
|
Definition
Usually last 3-7 days
Every 24-30 days
5-7 pads/day |
|
|
Term
| Dysmenorrhea, menorrhagia, metorrhagia |
|
Definition
| Painful, heavy, between periods |
|
|
Term
|
Definition
|
|
Term
|
Definition
Gravida- totaly # of pregnancies
Para- outcome of pregnancies |
|
|
Term
|
Definition
FPAL
Full term, premature, abortion, living |
|
|
Term
|
Definition
HPV
Early sex, multiple partners
h/o STD
not getting pap smears
smoking |
|
|
Term
|
Definition
| Position female is in during pelvic exam |
|
|
Term
|
Definition
|
|
Term
|
Definition
Pink- normal
Pale- anemia
Bluish- chadwick's sign- pregnancy |
|
|
Term
| CMT (Cervical motion tenderness) |
|
Definition
| Pelvic inflammatory disease |
|
|
Term
| Adenexal tenderness or mass |
|
Definition
Cyst- smooth, compressible mass
Ovarian torsion- tenderness, mass
Ectopic pregnancy- tenderness, mmass
Ovarian cancer- hard mass, tenderness |
|
|
Term
| Pelvic inflammatory disease |
|
Definition
b/l adenexal tenderness
Uternie tenderness
CMT
chandelier sign |
|
|
Term
|
Definition
| Heavy bleeding, intermenstrual bleeding, abdominal pain |
|
|
Term
|
Definition
Frothy discharge
Strawberry cervix |
|
|
Term
|
Definition
White, curdy discharge
Lab shoes branching hyphae |
|
|
Term
| Garderella vaginalis (bacterial vaginosis) |
|
Definition
|
|
Term
| Chlamydia or gonorrhoeae cervicitis (Mucopurulent cervicitis) |
|
Definition
| Yellow/green discharge, pus in os |
|
|
Term
|
Definition
Bladder herniates into vagina
Bulge on ANTERIOR wall |
|
|
Term
|
Definition
bladder and urethra herniate into vagina
Bulge on ANTERIOR wall |
|
|
Term
|
Definition
Herniation of rectum
Posterior wall of vagina |
|
|
Term
|
Definition
| from axilla, through nipples, down to pelvis |
|
|
Term
| How often should you get a breast exam? |
|
Definition
20-40 q3 years
>40 annually |
|
|
Term
|
Definition
annually/bianually beginning at 40, earlier with RFs
50-70 yo's get annual mammogram |
|
|
Term
| When to perform the breast exam |
|
Definition
| 5-7 days after menstruation |
|
|
Term
|
Definition
| Thick breast skin with prominent pores |
|
|
Term
|
Definition
| Usually hormonal, frequently pregnancy |
|
|
Term
| Persistent rash to nipple or areola, not healing |
|
Definition
|
|
Term
|
Definition
15-25
Single, round, rubbery, well delineated
Mobile
Nontender |
|
|
Term
|
Definition
30-50
Single or multiple
Round, less rubbery, mobile
TENDER |
|
|
Term
|
Definition
30-90
Single, IRREGULAR, HARD
FIXED
NONTENDER |
|
|
Term
|
Definition
| genetic mutations that predispose you for breast cancer |
|
|
Term
|
Definition
| age, female, dense breast tissue, relatives, genetics, ETOH, estrogen, inactivity, contraceptive pill, tall height, jewish |
|
|
Term
|
Definition
|
|
Term
|
Definition
Mid-stream clean catch
Refrigerate within 2 hrs |
|
|
Term
|
Definition
Fresh shouldnt smell bad
DKA- fruity or sweet
Retention/old- ammonia |
|
|
Term
|
Definition
Purine-rich foods
pyuria or lipiduria |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Rhabdomyolisis (break down of skeletal muscle) |
|
|
Term
|
Definition
Hematuria
beets/blackberries |
|
|
Term
| Normal specific gravity of urine |
|
Definition
|
|
Term
|
Definition
Increas intake, decrease gravity
determines hydration
More concentrated = higher specific gravity |
|
|
Term
| Decreased specific gravity |
|
Definition
| Diabetes insipidus, diuretic use, renal impairment |
|
|
Term
| Increased specific gravity |
|
Definition
| Dehydration, glycosuria, DKA, recent radioactive dye |
|
|
Term
|
Definition
|
|
Term
| Leukocyte esterase in urine |
|
Definition
Normally negative
Suggests bacteruria
Pyelonephritis or UTI |
|
|
Term
|
Definition
Normally negative
Gram-negative bacteria (e.coli)
Specific if positive, not sensitive
Only good for gram - UTIs |
|
|
Term
|
Definition
Normally negative
Screens for hematuria
Benign: menstruation, exercise...
Pathologic: kidnesy stones... |
|
|
Term
|
Definition
|
|
Term
|
Definition
Normally negative
Suspect DM |
|
|
Term
|
Definition
Normally negative
Result from fat metabolism
DKA
Could also be fever, anorexia, starvation etc |
|
|
Term
|
Definition
Do a 24hr urine
Diabetics, HTN, lupus at risk...
Early renal disease
>1gram/day VERY significant
>3.5g/day nephrotic syndrome |
|
|
Term
|
Definition
Doesnt show up on dipstick
multiple myeloma causes it |
|
|
Term
|
Definition
Usually negative
ONLY CONJUGATED (unconjugated is nonsoluble)
Will be from liver problems or obstruction, not just any proteolysis
Positive- evaluate liver for biliary obstruction or liver dysfunction |
|
|
Term
|
Definition
|
|
Term
|
Definition
Normally in urine in small amounts
Usually pooped out, might be in urine with hepatocellular disease (failure to remove from blood) |
|
|
Term
| Urine findings for Hepatitis, hemolysis, Biliary obstruction |
|
Definition
Hepatitis= yes bilirubin, yes urobilinogen
Biliary obstruction= Yes bilirubin, NO urobilinogen
Hemolysis = no bilirubin, strong positive urobilinogen |
|
|
Term
|
Definition
| Glomerular dz, distorted after passing through abnormal structure |
|
|
Term
| Epithelial cells in urine |
|
Definition
Squamous- can indicate contamination
Large numbers- possible neoplasm |
|
|
Term
|
Definition
| Severe tubular damage, glomerulonephritis |
|
|
Term
|
Definition
|
|
Term
| Granular casts or waxy casts in urine |
|
Definition
|
|
Term
|
Definition
| not pathologic (exercise, fever, dehydration..) |
|
|
Term
| Uric acid crystals in urine |
|
Definition
| Gout, dehydration, protein ingestion |
|
|
Term
| Prism-like "coffin lids" crystals in urine |
|
Definition
|
|
Term
|
Definition
Should be none
Are they symptomatic?
What type of bacteria? |
|
|
Term
|
Definition
| detects human chorionic gonadotropin (hcG) from placenta |
|
|
Term
|
Definition
False positive is rare! user error
False negative after missed period is low |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Rates chance of cardiac event in next 10 years |
|
|
Term
| LDL-lowering drug therapy |
|
Definition
Start with statin
(or bile acid sequestrant or nicotinic acid)
Consider higher dose of statin |
|
|
Term
|
Definition
Anyone over 65
COPD any age |
|
|
Term
| LH:FSH ratio is 2:1 or 3:1 |
|
Definition
| Polycystic ovarian syndrome |
|
|
Term
|
Definition
values of 4-8 may be BPH
PSA over 8 is usually cancer |
|
|
Term
| testicular cancer distribution |
|
Definition
| May be up to the mediastinum, retroperitoneal from the descent of the testes |
|
|
Term
| Thumb abduction tests for which nerve |
|
Definition
| Median- only nerve that innervates abductor pollicis brevis |
|
|
Term
Thalamus
Basal Ganglia
Hypothalamus
Internal capsule |
|
Definition
Thalamus- process sensory stimuli, transmit to cortex
Basal ganglia- effects movement
Hypothalamus- regulate temperature and homeostasis
Internal capsule- group axons together |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
