BOOK 2 FINAL QUESTIONS

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medic11
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BOOK 2 FINAL QUESTIONS
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2011-03-21 08:44:20
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Questions fr Book 2 3/22/11
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  1. A differential field diagnosis is described as. . . . .
    A list of possible causes for your patients symptoms
  2. Open ended questions allow your pt to what?
    Explain how he feels in detail, in his own words as opposed to answering yes and no.
  3. Closed end questions elicit what?
    Short answers to very direct questions
  4. When speaking of active listening what is reflection?
    Repeating your pt's words encouraging him to give more details
  5. When speaking of active listening what is clarification?
    Often in crisis, pt's will be vague. Asking for clarification will help narrow down the problem
  6. What is empathy?
    The act of feeling for your pt's when they feel frightened or ashamed
  7. Explain confrontation.
    Detecting inconsistencies in your pt's story and asking about them.
  8. Describe Interpretation.
    Interpreting observations and questioning your pt about you believe the problem is.
  9. A pt's chief complaint is what?
    Sign or symptom noticed by the pt or a bystander .
  10. The pt's primary problem is what?
    The principle medical cause for a pt's chief complaint
  11. What is active listening?
    The process of responding to your pt's statements w/words or gestures of understanding
  12. What are the 4 questions in the CAGE questionnaire?
    • 1.Have you ever felt the need to CUT down?
    • 2.Have you ever felt ANNOYED by criticism?
    • 3. Have you ever had GUILTY feelings?
    • 4. Have you ever had a drink as an EYE-OPENER in the morning?
  13. How do you calculate pack/yr hx?
    By multiplying the # of packs smoked/day by the # of yrs smoking
  14. What is tinnitus?
    The sensation of ringing in the ears.
  15. Define hemoptysis.
    Coughing up blood
  16. Define orthopnea.
    Difficulty breathing while lying supine
  17. What is paroxysmal nocturnal dyspnea?
    Sudden onset of SOB in the night
  18. What is hematemesis?
    Vomiting of blood
  19. What is polyuria?
    Excessive urination
  20. What is hematuria?
    Blood in the urine
  21. What is dysmenorrhea?
    Difficult or painful menstruation
  22. Gravida is equal to what?
    # of times a woman has been pregnant
  23. Para is equal too what?
    # of viable births a woman has had
  24. The process of normal inspiration is a/an ____ process involving ____ & ____ muscles.
    • active
    • diaphragm and intercostal
  25. In a pt w/a weak or irregular pulse assess the rate for ____ seconds.
    60
  26. The width of a correctly sized BP cuff should be what or what?
    • 1/2 - 1/3 the circumference of the pt's arm
    • 2/3 length of the pt's upper arm
  27. When taking a BP, deflate the cuf @ a rate of what?
    2-3 mmhg/HB
  28. Cyanosis is caused by an increase in ____.
    Deoxyhemoglobin
  29. A heavy and greasy scaling under the skin is called ____ ____.
    Seborrheic Dermatitis
  30. The tern that describes fine jerking movements of the eye is ____.
    Aniscoria
  31. The term for a common runny nose is ____.
    Rhinitis
  32. Epistaxis is simply know as a ____ ____.
    Bloody nose
  33. The most frequently dislocated joint is the ____.
    Shoulder
  34. Bruits is.......
    Sound of turbulent through an artery.
  35. Describe crackles.
    • Light, crackling non musical sounds heard usually during inspiration.
    • AKA Rales
  36. Describe wheezes.
    Continuous high pitched musical sounds similar to a whistle
  37. Describe Rhonchi.
    Continuous sounds w/a lower pitch and a snoring quality
  38. Describe stridor.
    Predominantly inspiratory wheeze asoc w/laryngeal obstruction
  39. What does a pleural friction rub sound like?
    Squeaking or grating sound of pleural linings rubbing together
  40. What is bronchophony?
    Abnormal clarity of pt's transmitted voice sounds.
  41. Whispered pectoriloquy is what?
    Abnormal clarity of pt's transmitted whispers
  42. Egophony is the term used to describe what?
    Abnormal change in tone of pt's transmitted voice sounds
  43. What is happening in the heart during diastole?
    Ventricles are relaxing
  44. What is happening in the heart during systole?
    The ventricles are contracting
  45. The sound in the heart made during S1 is ____ and is caused by what?
    • Lub
    • The closing of the tricuspid and mitral valves
  46. The sound in the heart made during S2 is ____ and is caused by what?
    • Dub
    • The closing of pulmonic and aortic semilunar valves
  47. Cardiac output is
    • The amt of blood the heart ejects each minute in mL's
    • CO = HR x stroke vol.
  48. Stroke volume is the ....
    Amt of blood the heart ejects in one beat.
  49. What are the 3 factors that determine stroke volume?
    • Preload (aka end diastolic pressure)
    • Contractile Force
    • Afterload
  50. Preload is the amount. . . .
    of blood returned to the heart from the body
  51. What is contractile force and what regulates it?
    • How forcefully the heart muscle contracts
    • Regulated by the autonomic NS and bodily needs
  52. Afterload refers to the . . . . .
    Resistance in the vessels that the heart must overcome to eject blood
  53. What is a thrill?
    Vibration or humming felt when palpating a pulse
  54. Where do we auscultate heart sounds of S1 & what do they sound like?
    • 5th intercostal space @ L sternal border & @ PMI
    • They are high pitched sounds
  55. Where do we auscultate heart sounds of S2 & what do they sound like?
    • 2nd intercostal space at the R & L sternal borders
    • High pitched sounds
  56. Cullin's sign is described as what?
    Discoloration around the umbilicus suggestive of intra-abdominal bleeding
  57. What is Grey-Turners sign?
    Discoloration over the flanks suggesting intra-abdominal bleeding
  58. Ascites is described as . . . .
    Bulges in the flanks & across the abd indicating edema fr CHF
  59. What is borborygmi?
    Loud, prolonged gurgling bowel sounds indicating hyperperistalsis.
  60. What are the 5 steps in evaluating a joint?
    • 1. Inspection
    • 2. Palpation
    • 3. Passive range of motion
    • 4. Range of motion against gravity
    • 5. Range of motion against resistance
  61. What is the curvature of a normal spine?
    Concave in cervical & lumbar regions and convex in the thorax
  62. A person w/exaggerated lumbar concavity (swayback) is said to have ____.
    Lordosis
  63. A person displaying exaggerated thoracic convexity (hunchback) is said to have ____.
    Kyphosis
  64. A person displaying lateral curvature of the spine has _____.
    Scoliosis
  65. What are the 5 areas for a neurologic exam?
    • 1. Mental status & speech
    • 2. Cranial Nerves
    • 3. Motor system
    • 4. Sensory System
    • 5. Reflexes
  66. The term dysarthria refers to:
    Defective speech caused by motor deficits
  67. Describe a lethargic pt.
    Drowsy, but answers questions appropriately b/f falling asleep again
  68. Describe the obtunded pt.
    Opens eyes and looks @ you but gives slow, confused responses
  69. Describe the stuporous pt.
    Arousable for short periods but is not aware of his surroundings
  70. Describe the comatose pt.
    State of profound unconsciousness and totally unarousable
  71. Name the 3 grades of memory.
    • 1. Immediate
    • 2. Recent
    • 3. Remote
  72. What are the 12 cranial nerves?
    • I Olfactory
    • II Optic
    • III Oculomotor
    • IV Trochlear
    • V Trigeminal
    • VI Abducens
    • VII Facial
    • VIII Acoustic
    • IX Glossopharyngeal
    • X Vagus
    • XI Accessory
    • XII Hypoglossal
  73. What is CN-I? What does it innervate & how doe we chk it?
    • Olfactory
    • Smell- Chked by evaluating ability to sense odors on each nostril
  74. What is CN-II? What does it innervate & how do we chk it?
    • Optic
    • Sight - Test visual acuity & field of view
  75. What is CN-III? What does it innervate & how do we chk it?
    • Oculomotor
    • Pupil Constriction - Chk pupils reactions
  76. What is CN-IV? What does it innervate and how do we chk it?
    • Trochlear
    • Superior Oblique muscles - Use "H" pattern test
  77. What is CN-V? What does it innervate and how do we check it?
    • Trigeminal
    • Opthalmic, Maxillary & Mandibular muscles - Checked by testing masseter muscle strength & sensation on forehead, cheek, chin & cornea
  78. What is CN-VI? What does it innervate & how do we test it?
    • Abducens
    • Lateral rectus muscles - Assess w/CN-III, IV using "H" pattern test
  79. What is CN-VII? What does it innervate & how do we test it?
    • Facial
    • Tongue & facial muscles - Checked by observing pt's face during conversations, looking for asymmetry, eyelid droop and abnormal movements
  80. What is CN-VIII? What does it innervate & how do we test it?
    • Acoustic
    • Hearing Balance - Checked by testing hearing and balance with eyes closed
  81. What is CN-IX? What does it innervate & how do we test it?
    • Glossopharyngeal
    • Posterior pharynx - Hoarseness of voice, difficulty swallowing. Have pt say ahhhh & watch for soft palate & uvula to rise symmetrically
  82. WHat is CN-X? What does it innervate & how do we chk it?
    • Vagus
    • Taste to posterior tongue, movement of posterior palate and pharynx. Chk by evaluating speech, swallowing, saying "ahhhh" and the gag reflex
  83. What is CN-XI? What does it innervate & how do we chk it?
    • Accessory
    • Traps & Sternocleidomastoid muscles - Examine for symmetry, Have pt shrug against resistance and hold pt's head & turn against resistance
  84. What is CN-XII? What does it innervated & how do we chk it?
    • Hypoglossal
    • The tongue - Assess speech articulation, midline projection
  85. What is the normal RR, HR & systolic BP of a newborn?
    • RR 30-60
    • HR 100-180
    • Systolic BP 60-90
  86. What is the normal RR, HR & systolic BP for an infant?
    • RR 30-60
    • HR 100-160
    • BP 85-105
  87. What is the normal RR, HR, & systolic BP for a toddler?
    • RR 24-40
    • HR 80-110
    • BP 95-105
  88. What is the normal RR, HR & systolic BP for a preschooler?
    • RR 22-34
    • HR 70-110
    • BP 95-110
  89. What is the normal RR, HR & systolic BP for a school age child?
    • RR 18-30
    • HR 65-110
    • BP 97-112
  90. What is the normal RR, HR & systolic BP for an adolescent?
    • RR 12-26
    • HR 60-90
    • BP 112-128
  91. Infants are classified as ____ to ____ year(s) old?
    Newborn - 1 year
  92. Toddlers are classified as ____ to ____ year(s) old?
    1 - 3 yrs old
  93. Preschoolers are classified as ____ to ____ year(s) old?
    3 - 6 yrs old
  94. School age children are between the ages of ____ and ____ .
    6 and 12
  95. Adolescents are between the ages of ____ and ____ .
    13 and 18
  96. What is the pulse pressure of a pt w/ HR 83, RR 14 & BP of 144/96?
    48
  97. In the tilt test what vital sign change is a positive sign of hypovolemia?
    BP drops by 10-20 mmHg or HR increases by 10-20 beats/min
  98. Where should a HR be assessed in a small child?
    Brachial
  99. When using an oral glass thermometer, it should be left in the mouth for ___ - ___ mins?
    3 - 4
  100. A normal O2 SAT w/o O2 is ____.
    96 - 100 %
  101. Bluish discoloration around the orbits is called ____ ____ or ____ ____ & is indicative of what?
    • Racoon Eyes or Periorbital Ecchymosis
    • Basilar Skull Fx
  102. The CN's that cause eye movements are ___, ___ & ___.
    III, IV & VI
  103. Otorrhea is a discharge fr the ear that may contain what 4 things?
    Blood, Mucus, Pus or CF
  104. The term for the common nose bleed is ____.
    Epistaxis
  105. The point of maximal impulse in an adult is located where?
    5th intercostal, mid clavicular
  106. What is the order of the heart valves as the blood flows fr the vena cavae?
    Tricuspid, Pulmonic, Mitral, Aortic
  107. The "lub" of the heart sounds represents which event of the cardiac cycle?
    Closing of the tricuspid & mitral valves
  108. Which abd organ is found in all 4 quadrants?
    Large intestine
  109. The type of movement permitted between the phalanges ____/____ .
    Flexion/Extension
  110. The type of movement permitted between the radius, ulna & humorous is what?
    Flexion/extension and Supination/Pronation
  111. The joint w/the greatest range of motion in the human body is the ____.
    Shoulder
  112. The type of movement permitted by the knee is what?
    Flexion/Extension w/ limited rotation
  113. Which region of the spine is most mobile?
    Cervical
  114. The mid and lower cervical spine permits which 4 types of movement?
    Flexion, extension, lateral bending & rotation
  115. A normal pulse quality would be reported as ?
    2+
  116. Pitting edema of 1/4" or less is scored as ____.
    1+
  117. Pitting edema of 1/4" - 1/2" is scored as ____ .
    2+
  118. Pitting edema scored at 3+ is how deep?
    1/2" - 1"
  119. Pitting edema scored @ 3+ is how deep?
    1" or more
  120. The term "dysphonia" refers too what?
    Voice changes due to vocal cord problems
  121. The term aphasia refers to what?
    Defective language due to neurologic problem
  122. The pyramidal pathway within the spinal cord mediates what?
    Voluntary Muscle Control
  123. To administer a Romberg test, have the pt what?
    Stand w/ eyes closed for 20-30 secs
  124. Babinski's response is pos when the sole of the foot is stroked and . . . .
    The big toe dorsiflexes and the others fan out
  125. When caring for a child, it is important too stay calm and be confident, direct and honest. True or False?
    True
  126. Children first recognize their parent's faces at what age?
    2 months
  127. Infants begin to sit up at about what age?
    4 - 6 months
  128. The most difficult pediatric age group to assess is the ____.
    Toddler
  129. Which age group is particularly distrusting of strangers?
    Preschoolers
  130. The soft spots in the skull called ____, close at about what age?
    • fontanelles
    • 18 months
  131. Bulging along the sutures of the skull of a young child suggests what ?
    An increase in ICP
  132. Because the tissues of a child's upper airway are so flexible, injuries, infections or minor obstructions don not adversely effect it as seriously as they would an adults. T or F
    False
  133. What is the patients primary problem?
    The underlying cause for their symptoms
  134. What is dysmenorrhea?
    Pain during menstruation
  135. What are Korotkoff signs?
    Sounds heard during the measurement of BP
  136. Define pulse pressure.
    The difference between systolic and diastolic pressure
  137. Anisocoria is defined as what?
    Unequal size pupils
  138. Pupillary accommodation is defined as what?
    pupils get larger as light gets closer
  139. Tactile fremitis is . . . .
    Palpable vibration
  140. What causes heart murmurs?
    Stiffing of the lg arteries caused by atherosclerosis
  141. Define borborygmi.
    Loud prolonged gurgling sounds
  142. Dugas Sign presents as an. . . .
    inability to bring shoulder to chest when checking for dislocation
  143. Levines sing is what?
    Clutching of the chest due to pain
  144. Name the 9 lymph node areas.
    • Submental
    • Submandibular
    • Supraclavicular
    • Retropharyngeal
    • Buccinator
    • Superficial Cervical
    • Jugular
    • Parotid
    • Retroauricular & Occipital
  145. Describe your test for ascites.
    Inspect abd for bulges in the flanks and across the abdomen indicative of edema fr. CHF

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