PA BLK Obj

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rc4754
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176327
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PA BLK Obj
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2012-10-08 19:44:03
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RC Patient Assessment
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PA Blk2 Obj
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  1. What are the four components of the physical examination?
  2. What is the importance of reviewing the history of  present illness before performing a physical examination?
  3. What is significant for the following to be found during an examination of the head and neck?
    Nasal flaring
    Cyanosis 
    Pursed-lip breathing
    Diaphoresis
    Changes in pupillary size in response to light
    Deviated tracheal position
    Jugular venous distension
  4. What is the correct method for measuring jugular venous pressure and what are normal findings?
  5. Describe how to find the topographic positioning of the following.
    Suprasternal Notch
    Sternal angle
    vertebral spinous process C7, T1
    Lung fissures oblique, horizontal
    Tracheal bifurcation A/P
    R/L Diaphragm A/P
    Lung borders
  6. Define:
    Pectus carinatum
    Pectus excavatum
    Kyphosis
    Scoliosis
    Kyphoscoliosis
    Barrel Chest
    Flail Chest
  7. Define:
    Apnea
    Biot's breathing
    Cheyne-Stokes breathing
    Kussmaul's breathing
    Apneustic
    Paradoxical breathing
    Asthmatic
  8. What are the breathing patterns associated with restrictive and obstructive lung disease?
  9. What is the significance of accessory muscles and retractions or bulging?
  10. Define:
    Abdominal paradox
    Respiratory alternans
    Peripheral cyanosis
    Central cyanosis
    Hoover's sign
  11. What are the causes of increased/decreased tactile fremitus?
  12. What are the causes for decreased thoracic expansion as assessed during chest palpation?
  13. Describe subcutaneous emphysema and the clinical significance?
  14. What are the causes of increased/decreased percussion?
  15. What are the four basic parts to a stethoscope and their use?
  16. How do you properly auscultate the lung?
  17. What are the four basic breath sounds?
  18. Define and explain mechanisms responsible:
    Tracheal
    Bronchovesicular
    Vesicular(normal)
    Diminished/absent
    Harsh/bronchial
  19. Define and explain mechanisms responsible:
    Crackles/rales
    Wheezes
    Stridor
    Pleural friction rub
  20. What are the qualifying adjectives used to describe lung sounds?
  21. What are the significance of the following?
    Monophonic wheeze
    Polyphonic wheeze
    Stridor
    Late-inspiratory crackles
    Inspiratory and expiratory crackles
    Pleural friction rub
  22. What is bronchophony and the cause?
  23. What are the locations of the apex and base of the heart?
  24. What,where is PMI and what are the causes for it shifting? 
  25. Where are the best locations for auscultating  sounds of the aortic, pulmonic , mitral,and tricuspid valve?
  26. What produces the S1,S2,S3,S4 heart sounds?
  27. What is a gallop rhythm and what is it indicative of ?
  28. What are the factors which increase or decrease the intensity of heart sounds?
  29. What is the significance of hearing a loud P2?
  30. What causes systolic and diastolic heart murmurs?
  31. Define hepatomegaly and explain its significance in the cardiopulmonary patient.
  32. Define and explain the significance of the following.
    Digital clubbing
    Cyanosis
    Pedal edema
  33. What are the components of the blood?
  34. What are the characteristics of blood serum and how is it obtained?
  35. What are the normal values for the following and significance of each?
    White blood cell count
    White cell differential
    Red blood cell count
    Hematocrit
    Hemoglobin
    Erythrocyte indices(mean cell volume, mean cell hemoglobin,mean cell hemoglobin concentration)
    Reticulocyte count
    Sedimentation rate
    Platelet count
    Coagulation studies(bleeding time, activated partial thromboplastin time, prothrombin time)
  36. Define the leukocytosis, leukopenia and explain some common causes of each.
  37. What are some common causes for the following white cell abnormalities?
    Neutrophilia
    Neutropenia
    Eosinophillia
    Lymphocytosis
    Lymphocytopenia
    Monocytosis
  38. Describe the effects of AIDS and AIDS-related complex have on the ratio of T-helper to T-suppressor cells.
  39. What are the characterisitics of leukemia and myeloproliferative disorders?
  40. What is a left shift?
  41. Define anemia and its common causes.
  42. What are the potential effects of anemia on oxygen-carrying capacity and tissue oxygenation?
  43. Define primary,secondary, and relative polycythemia and how it  affects blood oxygen transport and myocardial work.
  44. What are the implications of reduced platelet count?
  45. What are the normal values and significance of abnormalities for the following?
    Electrolytes
    Anion gap
    Sweat electrolyte concentration
    Blood urea nitrogen and creatinine
    Enzymes( aspartate aminotransferase, alanine aminotransferase,alkaline phosphatase, acid phosphotase, lactic deydrogenase,creatine kinase, amylase, lipase)
    Glucose
    Protein(immunoglobulins,albumin)
    Lipids(triglycerides,cholesterol,high/low density lipoproteins)
  46. What are the therapuetic levels for theophylline and what factos affect metabolism and clearance.
  47. Define:
    Normal flora
    Gram stain
    Culture
    Sensitivity
  48. What does a Ziehl-Neelson stain identify?
  49. How do you obtain a fresh and uncontaminated sputum sample?
  50. What are the factors involved in macroscropic sputum examination?
  51. What type of sputum is produced by bronchiectasis?
  52. What are the microscopic criteria used to determine a sputum sample is reliable?
  53. What is the significance of sputumeosinophilia?
  54. What organisms produced pneumonia and what are the common causes of bacterial pneumonia?
  55. Describe the indications and method of performing a bronchoalveolar lavage?
  56. Describe the significance of the following:
    Increased pleural fluid amount
    Milky pleural fluid
    Hemorrhagic pleural fluid
    Low protein content(Less than 3g/dl)
    High protein content(More than 3g/dl)
    High pleural fluid lactic dehyrdrogenase
  57. What is the significance of the following?
    Specific gravity
    pH
    Protein content
    Glucose concentration
    Ketones
    Bilirubin
    Blood
    Urobilinogen
    Nitrates
    Sedimentary constituents
  58. Explain the purpose of histologic and cytologic examinations.
  59. What are the malignant tumors responsible for producing most primary lung cancers?
  60. What type of pulmonary samples can be obtained cytologically?
  61. Describe the following regarding skin testing:
    Disease diagnosed
    Procedures for testing
    Significance and causes of anergy
    Use of the purified protein  derivative
    When a purified protein derivative is considered positive
    Effect of the bacille Calmette-Guerine vaccine on purified protein derivative

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