Gen Dia

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Gen Dia
2011-02-16 14:35:28

Part II
Show Answers:

  1. What is the O in OPQRST
    • Onset
    • this is attribute to symptom of present illness that would be taken at the time of history
  2. what is the P in OPQRST
    • Palliative/Provocative
    • this is attribute to symptom of present illness that would be taken at the time of history
  3. what is the Q in OPQRST
    • quality of pain
    • this is attribute to symptom of present illness that would be taken at the time of history
  4. what is the R in OPQRST
    • Radiating/ Referral such as from the nerve roots, facet joints
    • this is attribute to symptom of present illness that would be taken at the time of history
  5. what is the S in OPQRST
    • Site, Setting, Severity
    • this is attribute to symptom of present illness that would be taken at the time of history
  6. What is the T in OPQRST
  7. What would you be looking for in Past health history
    • Serios Illnesses
    • Previous injury
    • Hospitalizations
    • Surgeries
    • medications
    • allergies
  8. what is family health hx
    it is the occurence within the family of any medial condition that may affect thier medical condition.
  9. in an interview / health history what are the sobjects you want to hit
    • Chief hx
    • oast health hx
    • personal and social hx
    • review of systems
  10. If you have an alcoholic pt what questions should you ask
    • CAGE Questionare
    • C- Cutting down (have you ever felt the need to Cut down)
    • A- Annoyedby others criticisms
    • G- Guilty feeling
    • E- Eye opener
  11. what are the vital signs
    • Height and weight
    • pulse
    • Respiratory Rate
    • Bp
  12. Normals for Temperature
    • Oral - 98.6
    • Axilla- 97.6
    • Rectal and Tympanic- 99.6
    • Range 96-99.5F or 35-37.5C
  13. Pulse normal values
    • Adults 60-100
    • NewBorn 120-160
    • Elderly 70-80
  14. Respiratpry rate Normal
    • Adults 14-18
    • Newborn 44
  15. Blood Pressure Normal
  16. when measuring Bp what are you checking for
    Auscultory gap in palpatory systolic reading
  17. what is auscultory gap
    loss and reappearance of the pulsatile sound while listening with stethascore while cuff is deflating
  18. Korotkoff Sounds
    low pirch sounds produced by turbulent blood flow in the arteries
  19. what is Subclavian Steal Syndrome
    "Subclavian Steals" Bp reading 20% higher than in the lower extermities
  20. Tests for Vertebrobasilar Artery Insufficiency
    • Barre-Lieou
    • DeKleyns
    • Hallpike
    • Hautants
    • Underberg
    • Georges Test
    • not if any of these are positive refer to cardiovascualr specialist
  21. Ectropion
    lid turned outward
  22. Entropion
    lid turn inward
  23. Absent Redlight reflex
    not seen in cataract pts and newborns
  24. Cataracts
    Opacities in the eyes seen in diabetics and elderly
  25. Absent Red light reflex is normal in who
  26. Corneal Arcus
    • grayish opaque ring around the cornea.
    • Elderly >50yo -normal
  27. Pterygium
    trianglular thickening of the biulbar conjunctive that grows across the cornea and is brought on by dry eyes
  28. Hordoleum aka Sty
    infection of sabaceous glands causing a pimple or boil on the eyelid
  29. Chalazion
    Infection of miebomian gland causing a nodule which points inside the lid
  30. Pinquecula
    yellowish triangular nodule in the bulbar conjunctiva that is harmless and indicates aging
  31. Xantheslasna
    Fatty plaques on the nasal surface of the eyelids that is normal or indicates hyoercholesterolemia
  32. Argyll Robertson
    • bilateral small and irregular pupils that accomidate but do not react to light
    • seen with syphillis (prostitutes pupil)
  33. Internal Opthalmoplegia
    dilated pupil with ptosis and lateral deviation. DOesnt react to ligjt or accomidation
  34. Horners Syndrome
    • Ptosis
    • Miosis
    • anhydrosis
    • PAM is HORNEy
  35. HOrners Syndrome can cause an inturruption in _____
    Cervical sympathetic
  36. Glaucoma
    Cupping of optic disc due to intrsocular pressure
  37. Glaucomas s/s
    • Tunnels vision ( blurring of peripheral field)
    • Cresent sign of the cornea
  38. AKA Papilledema
    Choked disc
  39. Papilledema (choked Disc)
    • swelling of the disc due to Increased Intercranial Pressure.
    • there is NO visual loss.
  40. Retinal Detachment
    painLESS sudden onset of blindness.
  41. Pt with Retinal detachment will complain of
    curtain closing over vision and lightning flashes and floaters
  42. what is the mc reason for blindness in the elderly
    Macular Degeneration
  43. Drusen
    • ealrt sign if Macular Degneration
    • Describe as yellow deposits under retina
  44. Hypertensive Retinopathy
    damage to retinal vessels.
  45. hypertensive retiopathy characteristics
    cotton wool soft exudates.
  46. Diabetic Retinopathy
    affects viens more than arteries
  47. Diabetic retinopathy characteristics
    microanyueryms, hard exudates, and neovascularization
  48. Iritis
    Inflammation of the iris
  49. will you see Iritis with
    Ankylosing Spondylitis
  50. Emmetropia
    Normal vision
  51. Myopia
    Near sighted
  52. Presbyopia
    Loss of the elaasticity due to aging
  53. Hyperopia
  54. Name some abnormal finding of the ear
    • Tinnitus
    • Presbycussis
    • Acute Otitis Externa
    • Acute Mastoiditis
    • Purulent Otitis Media AKA Bacterial Otitis Media
    • Serous Otitis Media
    • Vertigo
    • Meniere's Disease
    • Benign Paroxysmal Positional Vertigo
    • Acoustic neuroma
    • Eustachian Tube Block
  55. Acute Otitis Externa
    • outer ear infection qith pain and inflammation.
    • Tugging of the pinna will be painful
  56. Acute Mastoiditis
    • Bacterial infection, commonly associated with hearing loss.
    • presents the same as acute otitis media
  57. Purelent Otitis Media aka Bacterial Otitis Media
    • Bacterial or viral infection of the middle ear.
    • tympanic membranes present with a red appreance
    • Purulent = bactrial = buldging
  58. Serous Otitis media
    • effusion in the middle ear usually from incomplete resolution of acute otitis media or obstruction of Eustachian tube
    • if chronic is amber with bubbles
  59. Mienieres Disease aka
    Endolymphatic Hydrops
  60. Endolymphatic Hydrops (Minieres Disease)
    disorder characterized by recurrent prostrating vertigo, sensory hearing loss, tinnitus and feeling fulness in the ear.
  61. Eustachiam Tube Block
    Retraction of the tympanic membrane
  62. Neuro Exam: Weber normal hearing
    equal sound heard bilaterally
  63. Neuro Exam: Weber
    Conduction hearling loss
    Lateraization to bad ear
  64. Neuro Exam: Weber
    Sensorial hearing loss
    Lateralizaton to good ear
  65. Neuro Exam: Rinne
    AC>BC (Rinne+)
  66. Neuro Exam: Rinne
    Conduction loss
    • AC<BC or =
    • (rinne -)
  67. Neuro Exam: Rinne
    Sensorial Hearing loss
    AC>BC with less TIME in bad ear
  68. Mouth and Throat abnormalities
    • Angualr Stomatitis aka Cheilosis
    • Candidiasis aks Thrush(Tongue)
    • Leukaplakia (Tongue)
    • Atrophic Glossitis
    • Fissured Tongue aka scrotal tongue
  69. Fissured Tongue aka Scotal tongue
    • Furros ont he surface
    • can be considered normal
  70. Atrophic Glossitis
    • vit B deficiency or iron
    • tongue is smooth and glossy
  71. Leukoplackia
    • PreCA lesions of white patches adherent to the surface
    • not easly removed
  72. Thrush
    • thick white fungal patches
    • they are easly scraped off.
  73. Giantism
    excessive growth hormone prior to skeletal maturity
  74. Acromegaly
    excessive growth hormone after skeletal maturity
  75. Hyperthyroidism
    • MC caused by Graves disease (autoimmune)
    • TSH decreased
    • T3/T4 increased
  76. Hypothyroidism
    Hashimotos mc cause
  77. Congenital Hypothyroidism is called
  78. Characteristics of Hyperthyroidism
    • Intolerance to heat
    • weight loss
    • Exophthalmos (bilat)
    • Increased T3 and T4
    • Decreased TSH
  79. Characteristics of Hypothyroidism
    • Macroglossia and loss of lateral 1/3 eye brows
    • Decrease T3 and T4
    • Increased TSH
  80. what acts as opposite to thyroid
  81. Characteristics of Common Migraine "sick" "vascular"
    • Photophobia, throbbing (worse behind the eye)
    • nausea
  82. Characteristics of classic migraine
    • Aura
    • will also incl characteristics of common migraine
  83. Characteristics of a Hypertension Migraine
    • Throbbing
    • wake up with a HA
  84. CLuster HA provoked by
  85. Site for muscular tension
    band like
  86. Temporal Arteritis is usually seen in
    over 50 yo females
  87. Characteristic of Subarachnoid Hemmorage
    • stiff neck
    • excruiciating pain like never before
  88. Characteristics of subdural hematoma
    • slow bleed following trauma
    • sxs evident days-week post injury
  89. Characteristics of post concussive HA
    • Loss of memory
    • visual disturbance
  90. Steps to examining thorax and lungs
    • Inspection
    • Palpation
    • Percussion
    • Ausculatation
  91. Deformities of the thorax
    • Barrel Chest
    • Pectus Excuvatum
    • Pectus Carinatum
  92. Barrel Chest
    • AP= lateral diameter
    • seen with COPD and cystic fibrosis
  93. Pectus Excavatum aka Funnel Chest
    marked depression noted in the sternum
  94. Pectus Carinatum aka pigeopn chest
    forward protusion of the sternum
  95. name respiration patters
    • Tachnypnea
    • Bradypnea
    • Biot's Breathing
    • Cheyne Stokes
    • Kussmaul's
  96. Tachnypnea
    Rapid shallow breathing
  97. Bradypnea
    Slow breathing
  98. Biot's Breathing
    characterized by groups of quick, shallow inspirations, followed irregular periods of apnea (no pattern)
  99. Cheyne Stokes Respiration
    • Breathing pattern characterized by alternating periods of apnea and hyperpnea (has a pattern)
    • Respiratory acidosis
  100. Kussauls Breathing
    • first rapid and shallow but as metabolic asidosis worsens,
    • breathing gradually becomes deep, slow, labored and gasping
    • "air hunger breathing"
  101. Abnormalities of Nails
    • Pitted
    • Splinter Hemmorage
    • Beau's lines
    • Paronychia
    • Clubbing
    • Koilonychia aka Spoon nail
  102. Pitted nails aka Inguinal Indentations
    Seen with Psoriasis also look for silver scales
  103. Splintter Hemmorage
    Subacute bacterial endocarditis (strep organism -red dots)
  104. Beau's Lines
    Transverse ridging associated with acute severe disease
  105. Paraonychia
    Onflammation of the nail fold near the cuticle
  106. Clubbing
    nail base has an angle > 180 degrees and may indicate hypoxia/COPD
  107. Koilonychia aka Spoon Nail
    Iron deficiency anemia
  108. Respiratory Excursion and Tactile Fremitis is done during what part of the thorac and lungs examination
    second part Palpation
  109. Respiratory Excursion
    Place hands over the posterior ribs and have the pt take a deep breath
  110. Tactile Fremitis
    • Palpable vibration
    • pt says 99
    • Increased with fluid (pneumonia)
    • decreased air (emphysema, pneumothorax)
    • decreased with atelectasis and plerisy bc sound barrier is created
  111. What are we looking for Percussion
    Tones and Diaphragmatic Excursion
  112. Resonant sound in the lungs during percussion
    are normal
  113. At what part of the Exam do you perform Diaphragmatic Excursion.
    • during Percussion
    • 1. Inspect
    • 2. Palpation
    • 3. Percussion
    • 4. Auscultation
  114. when do you hear hyperresonant tones during percussion
    Increased air in the chest (emphysema and pneumothoax)
  115. when do you hear dull tones during percussion
    Increased density (pneumonia and atelectasis)
  116. what are the four types of breath suonds
    • Vesicular
    • Bronchovesicular
    • Bronchial
    • Tracheal
  117. Vesicular breath sounds are heard during
    Insp longer than Exp
  118. what is the air sound heard at most of the lung
  119. Bronchovesicular breath sounds are heard during
    • Insp and exp
    • location: Ant 2-3 ribs bt scapula at apex
  120. Bronchial breath sounds are heard during
    • Exp longer than Insp
    • over the Manubrium
  121. Tracheal breath sounds are heard during
    • Insp equal Exp
    • Over trachea in neck
  122. When would you hear Rales (Bronchitis)
    when air opens closed air spaces
  123. When do you hear Ronchi (Bronchiectasis)
    Air is blocked or becomes rough through the large airways.
  124. Crackles aka
  125. Ronchi aka
  126. Wheezes are high pitched sounds heard in ___ condition
    • Asthma in young
    • Emphysema in older
  127. What are the test performed for Vocal resonance
    • Bronchophany
    • Egophany
    • Whispered pectriloquy
  128. Asthma
    • Percussion: Resonant
    • Fremitus: Decreased
    • Breath Sound: Wheezing
  129. Atelectasis
    • Percussion: Dull/Flat
    • Fremitus: Decreased
    • Breath Sound: Absent
  130. Bronchiectasis
    • Percussion: Resonant
    • Fremitus:Normal
    • Breath Sound: Ronchi
  131. Bronchitis
    • Percussion: Resonant
    • Fremitus: Normal
    • Breath Sound: rales (crackles)
  132. Emphysema
    • Percussion: Hyperresonant
    • Fremitus: Decreased
    • Breath Sound: Wheezing
  133. Pleurisy
    • Percussion: Resonant
    • Fremitus: Decreased
    • Breath Sound: Crackles (Friction Rub)
  134. Pneumothorax
    • Percussion: Hyperresonant
    • Fremitus: Decreased
    • Breath Sound: Decreased
  135. Pneumonia
    • Percussion: Dull
    • Fremitus: Increased
    • Breath Sound: Egophany, Bronchophony, Whispered Pectoriloquy, Crackles
  136. Lung Conditions
    • Lobar Pneumonia
    • Friedlander Pneumonia
    • Pneumocystis Carinii
    • Cytomegalovirus
    • Tuberculosis
    • Pluerisy
    • Pneumothorax
    • Atelectasis
    • Bronchiectasis
    • Chronic Bronchitis/COPD
    • Asthma
    • Emphysema
    • Bronchogenic Carcinoma
    • Costochondritis aka Tietze Syndrome
    • Herpes Zoster aka Shingles
    • Sarcoidosis
    • Hodgkins
    • Cystic Fibrosis
  137. Lobar Pneumonia
    • Consolidation of the lung
    • 10 days Rusty brown Sputum
    • silhoutte sign and air bronchogram
  138. Friedlanders Pneumonia
    Productive/ Current red jelly sputum
  139. Tuberculosis
    • Low grade fever, night swears
    • Ghon Lesions on film
    • starts in apices of lungs
    • tine test/mantoux test
    • positive purified protein derivitive
    • most definitive test- Sputum culture
  140. Pneumo thorax
    • rupture lung causing air to become trapped in the pleural space.
    • Unilateral darkening of chest film due to collapse lung
    • Tracheal shift AWAY from lesion .
  141. Pleursy
    • Inflammation of the pleura
    • stabbing chest worsened by respiration and cough
    • Dull on percussion
    • N. productive cough
    • positive friction rub
  142. orthopedic test for pleurasy
    Schepelmann's +
  143. Atelectasis
    • Collapse lung
    • tracheal deviat toward collapesed lung
  144. Chronic Bronchitis/COPD
    • Long term cough and mucus
    • Shortness of breath and wheezing
    • Cigarette smoking main cause
  145. Asthma
    • airways constricted, bronchspasm
    • Type I hypersensitivity rx
    • IgE rise
  146. Labs for Asthma
    • Curshmann's Spiral
    • Charcott Laden Crystals
  147. Emphysema
    • loss of elasticity of pulmonary connective tissue = Permanent dilation of avioli air sacs and caused by defiency alpha 1 anti trypsin
    • Hyperresonant percussion
    • decreased breath sounds
    • prolonged experation with expiratory wheeze
    • Fluid accumulates in costophrenic recess
  148. Bronchogenic CA
    • Primary malignant lung tumor
    • starts in bronchus

    • long term hx of smoking
    • n. productive cough MORE than 30 DAYS
    • dyspnea
    • weight loss
    • and clubbing of nails.
  149. ddx Bronchogenic CA and Pneumonia
    bronchogenic CA --> n. productive cough longer than 30 days

    Pneumonia --> rusty brown sputum and 10 days duration

    Both have cloudy white density of film
  150. Costochondritis aka
    Tietze Syndrome
  151. Tietze Syndrome
    • Inflammation of cartilage connection bt ribs and sternum
    • worsens with physical activity and deep breaths
    • palpable tenderness at COSTOsternal Articulation
  152. Herpes Zoster aka Shingles
    painful rash following CN V dermatome
  153. Sarcodosis
    • MC in African descent
    • disease in which abn collection of inflam cells
    • most often lungs or lymph nodes
  154. Sarcodosis X-Ray findings
    Bilateral hilar lymphadenopathy "angel wings, potato nodes"
  155. how is Hodgkins best diagnosed
    biopsy, looking Reed Sternberg Cells
  156. who usually has Hodgkins
    Causcasion males
  157. Hodgkins Disease
    CA of lympahtic systems that can spread to the spleen
  158. Cystic Fibrosis
    • CHronic Progressive
    • loss of excessive amounts of salt
    • COPD
    • Barrel Chest
    • Pranceatic insufficiency
    • meconium ilues
  159. In Cystic Fibrosis what gets thick accumilations of mucus
    intestines and lungs
  160. Jugular Venous Pulsation
    Measures the pressure of the right side of the heart.
  161. how can you make jugular venous pulsation more pronounced
    • when congestive heart failure is present
    • Apply pressure to the liver (hepatojugular reflex)
  162. During a heart palpation what do you check for
    peripheral pulses and thrills
  163. name peripheral pulses for the heart
    • Pulsus Magnus
    • Pulsus Parvus
    • Pulsus Alterans
    • Pulsus Bisferiens
    • Pulsus Paradoxus
    • Water Hammer Pulse
  164. Pulsus Magnus
    • Bounding; increased cardiac output
    • exercise
    • anxiety
    • fever
    • hyperthyroidism
  165. Pulsus Parvus
    • weak or thready; decreased stroke volume
    • hypovolemia (blood loss)
    • aoritc stenosis
    • chf
  166. Pulsus Alterans
    • Alternate in amplitude
    • left ventricular failure
  167. Pulsus Bisferiens
    • two strong systolic peaks seperated by mid systolic dip (best felt at carotid art)
    • aoritc regurgitation
    • aortic stenosis
  168. Pulsus Paradoxus
    • decreased amplitude on inspiration
    • increased with expiration (>10mmHg amplitude change)
    • COPD
    • bronchial asthma
    • emphesema
    • pericardial effusion
  169. Water hammer Pulse
    jerky pulse that is rapidly increasing anf the collapsing due to aortic insufficiency
  170. Thrills
    Vibration produced by turbulent blood flow within the heart (murmurs)
  171. Systole
    ventricle contraction
  172. Diasotle
    Ventricular relaxation
  173. S1
    closure of AV (mitral and tricuspid) valves
  174. S2
    Closure semilunar (pulmonary and aortic) valves
  175. S3
    • Ventricular Gallop
    • normal in kids, young adults and athletes
  176. when is S3 not normal
    >40 yo earliest sign of CHF
  177. S4
    • Atrial Gallop
    • similar to S3 and is related to stiffness of the ventricular myocardium to rapid filling
  178. Locations for Cardiac Auscultations
    • Aortic Valve - Right sternal border at 2nd intercostal space.
    • Best when pt is seated, leaning fwd, and exhaling
    • Pulmonic Vales - Left sternal border 2nd intercostal
    • Erbs point - Left sternal borderat 3rd intercostal space
    • Tricuspid Valve - Left sternal border at the 4th or 5th intercostal space
    • Mitral Valve - Mid-clavicular line at the 5th intercosal space Best auscultated in the left lateral decubitus position
  179. Murmurs during Diastole
    • A P
    • R R
    • M T
    • S S
  180. Stenosis
    • valve has trouble opening and the blood swirls through a narrow opening
    • Murmur has low pitch and best heard with the bell of a stethoscope
  181. Regurgitation
    Valve is insufficient and blood seeps or squirts back into chamber. THis murmur has a high pitch and is best heard with the diaphragm of stethoscope.
  182. What are the heart murmurs of the heart during systole
    • Aortic - Stenosis
    • Mitral - Regurgitation
    • Pulmonic - Stenosis
    • Tricuspid - Regurgitation
  183. name congenital heart defects
    • Patent Ductus Arteriosus
    • Tretralogy of Fallot (DRIP)
    • Coarcatation of the Aorta
    • Subclavian Steal Syndrome
  184. Patent Ductus Arteriosus
    • Failure of shunt to close bt the aorta and left pulmonary artery
    • Continuous/machinery like murmur that can be heard in both phases (diastole and Systole) of the heart cycle
  185. Tetralogy of Fallot (DRIP)
    • Dextraposition of the aorta
    • Right ventricular hypertrophay
    • Interventricular Septal Defect
    • Pulmonic Stenosis

    loud ejection murmur in systole and severe cyanosis
  186. Coarctation of the Aorta
    • Constriction of descending aorta (DISTAL left subclavian)
    • causes higher Bp in upper extremity than than lower by 20 mm Hg
  187. Coarctation of the Aorta is mc associated with
    Marfans Syndrome
  188. Subclavian Steal Syndrome
    • Narrowing proximal to the vertebral artery
    • Subclavian steals from vertebral
    • Seen young females who faint while exercising.
  189. Heart Conditions
    • Left sided heart failure
    • Right sided heart failure
    • Aortic Dissection
    • Angina Pectoralis-coronary vasospasm
    • myocardial infarction
    • aneurysm
  190. Left sided heart failure
    • MC cause of left sided heart failure is Hypertension
    • 2nd mc cause aortic stenosis
  191. Early signs of Left sided heart failure
    • Pulmonary edema (fluid in the lungsO causing shortness of breath (exertional dyspnea
    • Orthopnea
    • Fluid collects at costophrenic angles
  192. Right sided heart failure
    • MC cause of left sides heart failure
    • MC cause of mitral stenosis - rheumatic fever (ASO titer
  193. Cor Pulmane
    • when right side fails by itself
    • (lung condition that causes right sided heart failure)
  194. what will you see with Right side heart failure
    • stasis dermatitis
    • ascities
    • portal hypertension
    • caput medusa/spider angioma
    • pitting edema
  195. what is the first sign of congested heart failure
    exertional dyspnea
  196. what does the patient feels with an aortic dissection
    tearing pain
  197. Angina Pectoris-coronary vasospasm
    • comes on with exertion
    • Printzmetal angina comes on with rest (atypical)
  198. Myocardial Infarction
    • Acute failure womes with rest caused by atherosclerosis
    • CK-MB is elevated i
    • increased SGOT
    • Increased LDH
  199. Increased bowel sounds may indicate
    Early intestinal obstruction
  200. Absent bowel sounds may indicate
    • late intestinal obstruction
    • adynamic (paralytic) ileus
  201. hematemesis
    vomiting of blood
  202. Hemoptysis
    coughing of blood
  203. Hematochesia
    blood in stool
  204. Classis liver markers
    • GGT
    • SGPT/ALT
  205. what lab is non specific for liver
  206. jaundice
    Yellowing skin, sclera. and mucous membranes
  207. DDx for yellowing of skin
    • Jaundice - includes sclera
    • increased beta Carotene - only skin
    • Stasis dermatitis - ankles only
  208. Cirrhosis
    • Alcoholism is the MC cause of liver destruction
    • thiamin deficiency
  209. Mallory Wiess Syndrome
    • seen with cirrohosis
    • alcoholics
  210. THiamin Deficiency with out alcoholism
    Beri beri
  211. Wernicke Korsakoff Syndrome
    (area of brain affected) Thiamin dificiency leading to dementia
  212. Hepatitis A
    • enlarged but edge remains soft and smooth
    • from food through fecal/oral route, self limiting not a carrier
  213. Hepatitis B
    • Enlarged tender but edge remains smoothe and soft
    • dirty needles and sexual contact, carrier for life, MC to become liver CA
  214. Hepatitis C
    • enlarged tender smooth and soft edges
    • blood transfusion
  215. Liver Cancer
    • MC site for metastatic disease
    • liver is enlarged irregular border
  216. Direct and conjugated bilirubin
    • watersoluble gallstone (duct obstruction)
    • may cause urobilinogen
  217. Indirect and unconjugated
    • not water soluble
    • heilytic anemia - coombs test
  218. Gallbladder conditions
    • Cholecystitis
    • Porcelin Gallbladder
  219. gallbladder Pain referral
    to right shoulder or tip of right scapula (viscerosomatic)
  220. Cholecystitis
    • MC over weight >40yo
    • MC cause of cholelithiasis (gallstones)
    • Severe upper right quadrant pain
  221. Cholecystitis test
    Increased amylase and lipase
  222. Pocelain Gallbladder
    Calcification that can become malignant due to chronic inflammation
  223. Conditions of the pancreas
    • Pancreatitis
    • Pancreatic CA
    • Diabetes mellitus
    • Diabetes Insipidus
  224. Viscerosomatic pain for pancreatitis
    Epigastric pain straight through the back T10-T12 like a knife
  225. Grey Turners Sign
    bleeding into the flank seen in pancreatitis
  226. Cullens sign
    • Bruising/ pery umbilical ecchymosis
    • seen in etopic pregnancy and pancreatitis
  227. Lab tests for pancreatitis
    Increased amylase and lipase
  228. Labs for Diabetes Mellitus
    • Glucose Tolerance Test
    • Fasting Plasma Glucose
    • HbA1C
  229. Which other diseases does DM have an increased correlation with?
  230. DM vs DI
    • DM - Polydypsia, Polyphagia, polyuria
    • DI- Poly dypsia and polyuria
  231. Peptic Ulcer
    • Includes Duodenal and gastric ulcers
    • caused by H. Pylori bacteria
    • coffee ground emesis
    • burning epigastric pinpoint pain
  232. Duodenal ulcers
    • Pain occurs two hours after eating
    • BLACK/Tarry stool
    • MC type of peptic ulcer
  233. Lab for Duodenal ulcer
    Guaiac Test-Occult blood in the stool
  234. Virchows node seen in
    Stomach CA
  235. MC site for Stomach CA
    Lesser curvature and left supraclavicular lymph node (virchows Node)
  236. Mononuclieosis caused by
    Epstien Bar Virus 18-25 yo
  237. Mononeuclieosis is correlated to the ____ and has ____in the blood
    • Spleen
    • Atypical lymphocytes (downy Cells)
  238. Aka Monospot
    • Heterophile Aggulation
    • Paul Bunnel Test
  239. referral pain for small intestines
    Peri Umbilical
  240. Conditions of Small Intestines
    • Adynamic Ileus
    • Regional Ileitis aka Crohns Dz
    • Ulcerative Colitis
    • Irritable Bowel Sundrome aka Spastic Colon
    • Appendicitis
    • Diverticulitis
  241. Crohns Disease
    • Right side of the intestines (RLQ)
    • Patchy Inflammation (cobblestone appearance) does not absorb B12
    • chronic diarrhea
  242. how to diagnose Crohns dz (regional illeitis)
  243. Crohns can lead to
    malabsorption syndrome: tropical sprue/ celiac Sprue (gluten allergy)
  244. in whic small intestine condition will you find bloody mucus stool , diahrrea
    Ulerative colitis
  245. Appendicitis pain
    Dull periumbilical with radiation to lower right quadrant
  246. Shilling shift to the left to the left is in refrence to what condition
    Appendicitis - increased WBC
  247. Special test of appendicitis
    CT scan
  248. Diverticulitis
    • small outpuching within the colon
    • LLQ pain
  249. Adrenal conditions
    • Cushings Dz (aka Hyperadrenalism, hypercortisolism)
    • Addison Dz
    • Pheochromocytoma
  250. Characteristics of Cushings
    • Moon pie face
    • buffalo hump
    • purple striae in pendulous abdomen
    • hypertension
  251. Addisons dz
    • Hypoadrenalism; Hypocortisolism (decreased aldosterone)
    • decreased Bp
    • hyperpigmented mouth and face (bronze)
  252. Pheochromocytoma
    • Grey Cell Tumor of Adrenal Medulla
    • Increased epinephrine production (catecholamine)
    • Tachycardia, extreme hypertension
  253. What condition will be similar to the sign/symptoms of hyperthyroidism