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Clin Skills 4 Block 1

How to palpate the lateral breast? Patient's hand on the forehead with the hips rolled to the opposite side while keeping the shoulder pressed against the bed
Characteristics of a fibroadenoma of the breast? Firm, round, mobile, non-tender
Best method to conduct a breast exam? Fingers straightened, varying pressure, wedge/spokes of a bicycle
What can you see in a general exam of a pregnant woman? Chloasma (darkening of the face)
What position should the fetus be upon palpation before delivery? Flexed attitude (cephalic prominence is at the same side of the elbows and knees)
Patient is 24 weeks pregnant, what should be the fundal height? 24cm
What is the cause for the baby being small for date? Oligohydramnios
How do you insert a speculum? Slide it in over the dorsum of two fingers either slightly tilted (1 and 7) or in the horizontal plane
What should the cervix look like when pregnant? When in menopause? Blue with mucous plug. Pale
What is the technique for a bimanual pelvic exam? Abdominal hand moves to the lateral lower quadrant
What is a perfect APGAR score? Appearance should be pink all over, Pulse should be greater than 100, Grimace should be a cry, sneeze, or cough. Activity should have movement. Respirations should be strong. (10/10)
How do you test for edema of the caput? Firm, constant pressure in one spot
What condition would indicate pathology in a newborn? White pupillary reflex
Why do you examine the hips of an infant and what are the techniques? To rule out developmental dysplasia of the hip. Barlow's and Ortolani's maneuvers
Do you use prophylaxis against gonococcal opthalmia in newborns via C-section? Yes, ALL newborns get it
When do you do a comprehensive assessment of a patient? When a new patient presents to a clinic or hospital
What things are included in the patient's perspectives? Ideas, concerns, expectations, impacts, and emotions
What section of the note does childhood illnesses and hospitalizations go in? Past medical history
What are the characteristics of herpes? Painful vesicles leading to shallow ulcers
What is the deep ring test for a hernia? Patient coughs while pressing on the deep inguinal ring. If the hernia comes out, then it is a direct hernia.
What is the silk sign suggestive of? Indirect inguinal hernia
What is the bell clapper deformity and what does it increase risk of? High attachment of the tunica vaginalis. Increases risk of torsion. Has a negative Prehn's sign
What do you do if the thyroid is enlarged? Auscultate for bruits
Where are the lateral lobes of the thyroid located? From the thyroid cartilage to the 4th tracheal ring
What is orthopnea seen in? Ventricular heart failure or mitral stenosis
How do you tell if a pulsation is carotid or jugular? Carotid pulsations do not change based on patient's position
What is the patient's position when palpating the apical impulse? Rolled to the left
What does inspiration during auscultation cause? Physiological splitting (P2 moves further from A2)
What grade is a really loud murmur? 3
What happens to mitral valve prolapse upon squatting? The click is delayed and the murmur shortens
What does it mean if a patient is standing with their breath held and they have an intense murmur? Hypertrophic cardiomyopathy
A patient's murmur intensifies upon squatting, what is it? Aortic stenosis
Where is physiological splitting best heard and when does it disappear? At the pulmonary valve, disappears on expiration
An 18 year old has an S3 sound, what do you tell his parents? It is normal in young adults
What causes an S4 sound? Poorly compliant ventricles
A crescendo-decrescendo systolic murmur is? Aortic stenosis
Mid-late diastolic murmur is? Mitral stenosis
What test can be used to check for arterial insufficiency? Postural color change
Heart rate above 100 bpm with regular intervals is? Sinus tachycardia
L1 +ve, aVF +ve = L1 +ve, aVF -ve = L1 -ve, aVF +ve = normal LAD RAD
ECG with varying R-R intervals and fibrillatory waves is? Atrial fibrillations
ECG with irregular intervals, biphasic P and inverted T waves is? Sinus sick syndrome
ECG with crazy shit all over the place is? Torsades du Pointes
ECG with tombstoning is? STEMI
What are some red flags for lethal family violence? History of domestic violence and death threats
What are some obstacles to leaving abuse? Isolation, no support or counselling, denial, shame, religion, culture, fear
What is an important aspect of personal and social history? Family status
When do you use PEACE or HITS? When the patient doesn't feel safe, there are signs of abuse, there are red flags
What is an important aspect of risk assessment? Are there children involved?
What is included in the subjective part of the note? Patient's perspective and emotions
What is an abrasion? Loss of partial thickness of skin from friction
What is a hematoma? A collection of blood due to injury to a blood vessel
Pansystolic (holosystolic) murmur is? Mitral regurgitation
Crescendo systolic murmur is? Mitral valve prolapse
Early diastolic decrescendo murmur is? Aortic regurgitation
Created by: ASG32
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