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CS IV B1
Clin Skills 4 Block 1
| Question | Answer |
|---|---|
| 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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