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WCM II Exam I
Western Clinical Medicine Winter 2013 Exam I
| Question | Answer |
|---|---|
| What is the purpose of palpation during a respiratory exam? | To feel for vibrations caused by consolidation (i.e. - pneumonia) |
| What is an ABG? | Arterial Blood Gas - checks oxygenation of pulmonary artery blood |
| What does spirometry measure? | The amount and rate of air that a patient breathes |
| What is respiratory distress syndrome? | Alveolar collapse and lack of surfactant in premature infants |
| What causes SIDS? | Abnormal ventilation allowing for CO2 buildup, periods of apnea and cardiac arrhythmias |
| What is croup? | Severe inflammation and obstruction of the upper airway |
| What causes acute respiratory distress syndrome? | A non-cardiac cause that increases the permeability of the alveolocapillary membrane |
| What is pulmonary edema? | accumulation of fluid in the extravascular spaces of the lungs |
| What typically causes pulmonary edema? | Left sided heart failure |
| What is atelactesis? | Collapsed lung |
| What is a pneumothorax? | The accumulation of air/gas between the parietal and visceral pleura |
| What are the two types of pneumothorax? | Spontaneous (occurs in healthy person) and secondary (occurs as a complication of underlying LU disease) |
| What are signs/symptoms of a pneumothorax? | Sharp chest pain, asymmetrical chest motion, dyspnea, decreased breath sounds on affected side |
| What is a pulmonary embolism? | An embolism that has lodged in the lungs, typically originating from a distal location in the body |
| What are the three types of sounds heard on percussion? | Tympanic - heard over a hollow organ; Resonant - heard over an organ with some air; Dullness - heard over "solid" tissue |
| What is acute bronchitis? | Inflammation of the middle airways |
| What are some signs/symptoms of acute bronchitis? | Productive cough, possibly fever, some wheezing or rhonchi (indicating fluid) |
| What is pneumonia defined as? | An acute infection of lung tissue that commonly impairs gas exchange |
| Do vaccines exist for pneumonia? | Yes |
| What is aspiration pneumonia? | Pneumonia secondary to inhaling gastric contents |
| Which type of organism is part of the criteria when diagnosing AIDS (in relation to pneumonia)? | Pneumocystis carinii |
| What is pleurisy? | An inflammation of the visceral and parietal pleura |
| What is secondary to what types of conditions? | Pneumonia, TB, viruses, SLE, RA, PE |
| What are signs and symptoms of pleurisy? | Sharp, stabbing pain that increases with deep breaths, dyspnea, pleural friction rub during late inspiration/early expiration, increased tactile fremetis |
| What is a granuloma? | A collection of macrophages that form to wall off substances perceived as foreign but unable to be eliminated by the body |
| What is the primary disease associated with the formation of granulomas? | Infectious TB |
| What bacteria causes tuberculosis? | Mycobacterium tuberculosis |
| Is TB an acute or chronic infection? | It can be either |
| What are signs and symptoms of TB? | Non-specific fatigue, weight loss, night sweats, low grade fever, cough |
| How is TB identified in a patient? | With a + TB test (skin test) and/or a chest x-ray |
| What are the three types of fungal mycoses? | Blastomycosis, Histoplasmosis and Coccidiomycosis |
| Where is blastomycosis found, and who does it normally affect? | South-central, south-eastern and midwestern USA; Affects farmers, hunters campers |
| Where is histoplasmosis found and how is it transmitted? | Eastern and central USA; transmitted from bird/bat droppings when soil spores are disturbed |
| Where is coccidiomycosis found? What is an alternate name for it? Under what conditions is it spread? | Western and Southwestern USA; Valley Fever; droughts, farming, even earthquakes can stir up spores |
| What is sarcoidosis? | A multisystem, granulomatous disorder producing lymphadenopathy, pulmonary infiltration and skeletal, liver, eye or skin lesions. |
| What are some signs of sarcoidosis? | If respiratory: cough, dyspnea, substernal pain, cutaneous nodules |
| What type of cancer does asbestosis/silicosis cause? | Mesothelioma |
| What is COPD? What is it defined as? | Chronic Obstructive Pulmonary Disorder; Progressive loss of lung function |
| What is asthma? | An intermittent attack of dyspnea and wheezing, chest tightness, and productive cough |
| Is asthma marked by decreased inspiration or decrease expiration? | Decreased expiration |
| What is the most common cause of respiratory death in the US? | Emphysema |
| What is the cause of congenital emphysema? | Deficiency of alpha-antitrypsin |
| What are signs and symptoms of emphysema? | Dyspnea, weight loss, barrel chest, pursed lip breathing and tachypnea |
| To what part of the body does LU cancer often metastasize? | The spine |
| What is a Pancost tumor? How does it present? | Cancer in the apices of the lung; As pain in the neck and shoulder regions. |
| What are the three common types of abdominal pain? | Inflammatory (steady, acute onset pain), obstructive (colicky pain) and vascular (constant continuous ache) |
| What is cholecystitis? | Inflammation of or stones in the gall bladder |
| What do LV/GB and duodenal pain refer to? | The right shoulder/inferior scapula |
| Where do pancreatic, stomach, and duodenal pains refer to? | Midback region |
| What type of diagnostic tests are used to determine GI issues? | Barium swallow, barium enema, Upper/Lower GI endoscopes, Endoscopic Retrograde Cholangiopancreatography(ERCP), Laparoscopy, labs |
| Which test is used to examine the biliary and pancreatic ducts | ERCP |
| What chemicals are often looked for on a chem screen? | Bilirubin and cholesterol |
| What type of anemia can intestinal bleeding cause? | Iron anemia |
| To what long term condition can esophageal spasms lead? | Achalasia - esophageal sphincter fails to relax |
| What is GERD? | Gastroesophageal reflux disease |
| Which type of infection can cause GERD? | Heliobacter pylori |
| What is Barrett's esophagus? | The lining of the esophagus is damaged d/t long term exposure to stomach acid |
| To which type of cancer is Barrett's esophagus a precursor? | Adenocarcinoma |
| What are the two types of hiatal hernia? | Sliding and paraesophageal |
| What is a sliding hernia? | When the stomach and gastroesophageal junction both slip up above the hiatus |
| What is a paraesophageal hernia? | When the greater curvature of the stomach rolls through the diaphragmatic defect |
| What is Mallory-Weiss syndrome? | When there is a non-penetrating tear that occurs in the distal esophagus |
| What is gastritis? | Inflammation of the gastric mucosa |
| What type of anemia can chronic gastritis cause? | Pernicious (B12 deficiency) anemia |
| What tests are used to check for Heliobacter pylori? | Blood tests (looking for antibodies), fecal test (looking for H. pylori proteins) and urea breath test |
| What is a cardinal sign for a stomach ulcer? | Slight pain that is relieved by eating |
| What is a peptic ulcer? | Circumscribed lesions of the mucosal membrane |
| What percentage of peptic ulcers are duodenal? | 80% |
| What are the three major causes of peptic ulcers? | 1. Heliobacter pylori 2. Excess use of NSAIDs 3. Hypersecretory disorders (such as Zollinger-Ellison syndrome) |
| What is Zollinger-Ellison syndrome? | Condition caused by tumors that produce excess gastrin, increasing stomach acid production |
| If a patient has a bleeding peptic ulcer, what color will their stool be? | Dark in color |
| What is celiac disease? | Poor absorption of food, gluten intolerance |
| What type of children specifically often present with GI disorders? | Children on the autism spectrum |
| How is celiac disease diagnosed? | Biopsy revealing mosaic pattern that is the result of an abscence of villi |
| What is steatorrhea? | Fatty stool |
| What is diverticulitis? | Bulging pouches in the GI wall that push mucousal lining through surrounding muscle which are inflammed |
| What can cause diverticulitis? | Insufficient fiber, old age |
| What is appendicitis? | Inflammation, infection or obstruction of the appendix |
| What is a cardinal sign for appendicitis? | + rebound tenderness |
| What type of pain does appendicitis initially present with? | General periumbilical pain |
| When appendicitis pain localizes, where does it localize to? | The lower right quadrant |
| What is pancreatitis? | Acute OR chronic inflammation of the pancreas |
| What are the two most common conditions that cause pancreatitis? | Alcoholism and biliary tract disease |
| Where does the pain of pancreatitis typically manifest? | Epigastric pain radiating between the tenth thoracic and lumbar vertebrae, unrelieved by vomit |
| What two enzymes are elevated in serum levels in cases of acute pancreatitis? | Amylase and lipase |
| What is often a condition of chronic pancreatitis? | Malabsorption |
| What is peritonitis? | Acute or chronic inflammation of the peritoneum, may extend through or be localized as an abscess |
| What are signs and symptoms of peritonitis? | Sudden, severe, diffuse abdominal pain that tends to intensify and localize in the area of inflammation; weakness, pallor, SHOCK |
| What is cholelithiasis? | Calculi that occur as a result of changes in bile components |
| What is cholecystitis? | Acute or chronic inflammation of the gall bladder |
| Which type of viral hepatitis may self resolve? | Hepatitis C |
| What symptoms does hepatitis initially present with? | Significant fatigue, anorexia, general malaise |
| Why is urine often dark in cases of hepatitis? | Because of the increased concentration of bilirubin |
| What is one of the most important markers to be familiar with when looking for hepatitis? | The Hep B surface antigen |
| What is a caput medusa? | A pattern of veins that manifests over the surface of a distended abdomen |
| How can you tell the difference between Hepatitis A and cirrhosis of the liver? | In Hep A, liver enzymes are very high. In a cirrhotic liver, liver enzymes are very low |
| What can cause non-viral hepatitis? | Carbon tetrachloride, trichloroethylene, mushrooms, certain medications, autoimmune disorders |
| What is asterixis? | Involuntary motion, sometimes seen as a CNS complication of liver disease |
| Issues with which three systems are typically what kill people with liver disease? | Respiratory, CNS and hematology |
| What are some endocrine issues commonly seen with cirrhosis? | Testicular atrophy, gynecomastia, loss of body hair |
| What color is the stool in cases of cholelithiasis? | Clay colored, because it lacks bile |
| What is the most common GI cancer? | Colon cancer |
| What are some signs/symptoms of colon cancer? | Local obstruction, hematochezia (bright red blood in the stool), anemia (pernicious and Fe deficient), abdominal aching |
| In which populations is ulcerative cholitis common? | Young people, people of Jewish origin |
| What symptoms are often seen with ulcerative cholitis? | Weight loss, abdominal pain, anemia, and rectal abscesses |
| What are the treatments for ulcerative cholitis? | Supportive care, colon resection, cholostomy bag |
| What percentage of kidney function must be lost before signs of kidney failure appear? | 75% |
| What is BUN? | Blood Urea Nitrogen (a waste product) |
| What is a urinary cast? | A mold of the kidney tubules formed by precipitation of mucoproteins |
| Which type of polycystic kidney disease is fatal? | Infantile |
| What is the treatment for polycystic kidney disease? | Dialysis and transplant |
| What is acute pyelonephritis? | A bacterial infection of the interstitial tissues of the kidney |
| What is vesicoureteral reflux? | Retrograde flow of urine from the urinary bladder |
| What are some cardinal signs of acute pyelonephritis? | Urgency, frequency, burning upon urination, fever, shaking chills and flank pain |
| What is acute post-streptococcal glomerulonephritis (APSGN) | Bilateral inflammation of the glomeruli following an upper respiratory strep infection |
| What are some signs/stymptoms of APSGN? | Oliguria (reduced urination), + anti-streptolysin O antibody titers |
| What is acute tubular necrosis? | Damage to the kidney tubules from toxins or ischemia |
| What are some red flags of acute tubular necrosis? | Decreased output, symptoms of uremia, elevated BUN, creatinine |
| What are renal caliculi? | Kidney stones |
| What is lithotripsy? | A delivery of shock waves to break up large kidney stones |
Created by:
eippolito
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