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Biomed
Biomed for NCCAOM 2019
| Term | Definition |
|---|---|
| Compartment Syndrome | Serious condition involving inc. pressure, can lead to muscle and nerve damage and blood flow problems. Acute or chronic, resulting from trauma or overuse. Emergency situation, bc insufficient blood supply could lead to loss of limb. Fasciotomy is tx. |
| 6P S/S of Compartment Syndrome | Pain, Pallor, Pulselessness, Paresthesia, Paralysis, Poikilothermia (inability to regulate core body temp) |
| Ehlers-Danlos Syndrome | A group of genetic connective tissue disorders characterized by unstable, hypermobile joints, loose, "stretchy" skin, and fragile tissues. |
| Raynauds Syndrome | Hands appear white (no blood flow) to blue (zero oxygen) to red (return of blood flow) Causd by Crest Syndrome, emotional stress |
| Carpal Tunnel Syndrome Def. | Entrapment of the median nerve, decrease in size or space of the carpal tunnel, leading to paresthesia, pain or occasional paralysis. |
| Carpal Tunnel Syndrome causes | Can be precipitated by overuse of wrist flexors, diabetes mel, or a thyroid dysfunction. Commonly occurs in pregnant and middle aged women. |
| Carpal Tunnel Syndrome S/S | Aching over thenar eminence of hand and proximal forearm and may extend into shoulder. WORSE AT NIGHT or when wrists flex or extend. |
| What long standing Syndrome can lead to thenar atrophy | Carpal Tunnel Syndrome |
| Tests for Carpal Tunnel Syndrome | Phalen's maneuver (plus reverse Phalen's) and Tinel's Sign |
| Medial Epicondylitis | Chronic elbow pain, aka Golfer's Elbow, Reactive tendon pathology of flexor forearm muscle. Pain is worsened with wrist flexion and felt along SI channel on forearm as well. Caused by repetitive stress |
| Lateral Epicondylitis | Chronic elbow pain, aka Tennis Elbow Reactive tendon pathology of extensor forearm muscle Lateral upper forearm pain/tenderness, worsened with extending the wrist or grasping things Caused by repetitive stress |
| Osteoporosis | Common metabolic bone dz characterized by low bone mass (T-score = -2.5 or lower) and architectural disruption. |
| Osteoporosis S/S | Hip fractures, vertebral compression fractures, loss of height, progressive thoracic kyphosis, and/or distal Radius fractures (colles fractures) following minimal trauma. |
| Osteoporosis | Risk factors: smoking, age, corticosteroid use, xs caffeine or alcohol intake, amenorrhea, eating disorders. |
| Osteoporosis DX: | DEXA (dual xray absorptiometry) measuring T score. T score: -1 or higher=normal -1 to -2.5=osteopenia -2.5 or lower= osteoporosis |
| Osteoporosis TX: | prevention, treatment with calcium and vit D supplements. |
| Rotator Cuff | Supraspinatus: Infraspinatus: Teres minor: Subscapularis |
| Teres minor | adducts and externally rotates |
| Infraspinatus | externally rotates |
| Supraspinatus | abducts (initially before the deltoid) most common RC injury |
| Subscapularis | adducts and internally rotates |
| Tests for rotator cuff tear | Drop arm test, Hawkins kennedy, and the Apprehension test |
| Bicipital tenosynovitis DX: | Yergason's test and speed test |
| Bunion | Deformity of the joint connecting the big toe to the foot Also called Hallux abducto valgus |
| Valgus | usually refers to knees coming inward while feet go outward, but in this case refers to toes going outward from the joint that protrudes inward |
| Varus | usually means knees go outward Tx: splint or surgery |
| Plantar fasciitis | Pain in heel and bottom of foot usually worse with first steps of the day, or after rest. Most common cause of heel pain. The fascia can be torn or inflamed. |
| Mortons Neuroma | Benign neuroma of the intermetatarsal plantar nerve most common between the 3rd and 4th intermetatarsal space but also found between the 2nd and 3rd, resulting in entrapment of affected nerve. |
| Mortons Neuroma S/S | -Pain and/or numbness relieves sometimes by moving Some consider not a true tumor, but a neurofibroma. |
| Mortons Neuroma Tx | orthotics, corticosteroid injection, possibly a pad placed under the metatarsal |
| Secondary Cancer | Called by the name of the first location, ie if pancreatic cancer metastasizes and spreads to the liver, the cancer in the liver is called pancreatic cancer. |
| Benign tumors | do not spread or metastasize. |
| Metastasis | definitive criteria for malignancy |
| Metaplasia | A change of cells to a form that does not normally occur in the tissue in which it is found. |
| Hyperplasia | proliferation of cells that increases over all size of tissue |
| Neoplasm | abnormal cell proliferation creating new tissue |
| Dysplasia | the increased growth of immature cells with a simultaneous reduction in the growth of mature cells, their numbers and their site of growth |
| Biopsy | the most definitive diagnostic method for cancer |
| Benign tumors | Grow slow |
| Benign tumors | Well defined capsule |
| Benign tumors | Non invasive |
| Benign tumors | Well differentiated |
| Benign tumors | Low mitotic index |
| Benign tumors | Do not metastasize |
| Benign tumors | Good prognosis |
| Malignant tumors | Grows rapidly |
| Malignant tumors | Non encapsulated |
| Malignant tumors | Invasive |
| Malignant tumors | Poorly differentiated |
| Malignant tumors | High mitotic index |
| Malignant tumors | Poor prognosis |
| Lipoma | Benign adipose tissue tumor |
| Osteoma | Benign tumor of bone |
| Leiomyoma | Benign tumor of the smooth muscle (ie uterus, stomach) |
| Rhabdomyoma | benign tumor of striated muscle |
| Pheochromocytoma | benign tumor of adrenal medulla |
| Teratoma | benign tumor made up of several different types of tissue, such as hair, muscle, or bone. They typically form in the ovaries, testicles, or tailbone and less commonly in other areas |
| Highest Incidence tumors/cancer in men | 1. Prostate 2. Lung 3. Colon |
| Highest Incidence tumors/cancer in women | 1. Breast 2. Lung 3. Colon |
| Highest Mortality tumors/cancer in men | 1. Lung 2. Prostate 3. Colon |
| Highest Mortality tumors/cancer in women | 1. Lung 2. Breast 3. Colon |
| #1 risk for bladder cancer | Smoking |
| Lymphoma | malignant tumor of lymphoid tissue |
| Carcinoma | malignant cancer of epithelial cells |
| Sarcoma | malignant cancer of connective tissue |
| Colon cancer | Screening starts at 50 years old every ten years unless pt has a family Hx |
| Breast cancer risk factors | nulligravida (zero pregnancy), early menarche, sister with breast cancer, family hx, more time menstruating. |
| Types of skin cancer | Basal cell carcinoma, Squamous cell carcinoma, melanoma |
| Basal cell carcinoma | - most common type of skin cancer - Found in sun exposed areas - Telangiectasia (blood vessels seen) rolled borders, central ulcer, - tx= surgical resection |
| Squamous cell carcinoma | 2nd most common skin cancer Assoc. w/ excess exposure to sunlight & immunosuppression and arsenic Found mostly on face & upper lower lip |
| Squamous cell carcinoma | precursor= Actinic Keratosis (a precancerous patch of thick, scaly, or crusty skin) Locally invasive, it may spread to lymph nodes and will rarely metastasize |
| Melanoma | Most common cause of death related to skin cancer Significant risk of metastasis Depth of tumor correlates to prognosis and risk of metastasis precursor=dysplastic nerves |
| Melanoma signs "ABCDE" | Asymmetry, Border irregularity, Color variation, Diameter >6mm, Evolution over time |
| Fitzpatrick scale | Predicts cancer risk based on color of skin |
| Epithelial tissue | lining, transport secretion, absorption Gi tract, hollow organs, skin surface |
| Connective tissue | support, strength, elasticity bone, tendon, fat |
| Muscular tissue | movement cardiac, smooth, skeletal |
| Nervous tissue | information synthesis, communication, control brain, spinal cord, nerves |
| Range of Motion | The linear or angular distance that a moving object may normally travel while properly attached to a fixed point. Each specific joint has a normal range of motion expressed in degrees |
| Active ROM | px performs movement unassisted |
| Passive ROM | therapist moves with no help from PX |
| Goniometer and inclinometer | used to measure ROM |
| Type of muscle | shape, #nuclei, striation, voluntary/involuntary |
| Skeletal muscle tissue | elongated shape, multiple nuclei, striation, voluntary |
| Cardiac muscle tissue | branching shape, single nuclei, striation, involuntary |
| Smooth muscle tissue | spindle shaped, single nuclei, not striated, involuntary |
| Acanthosis Nigricans | darkening of skin at body folds esp around neck and axilla. Sign of diabetes |
| Lichen Planus | (6p): Pruritus, Papule, Plaque, Purple, Polygal, Planar |
| Nerve | targeted and specific, chemical and electrical |
| Endocrine | slow, chronic control, continues after stimulation stops |
| Hypothalamus | Master gland controlling both nervous system and endocrine via interaction with pituitary |
| Thyroid produces | T3, T4, and Calcitonin |
| Calcitonin | targets bone. It decreases blood Ca, increases Ca deposition and ossification |
| Graves Disease | also known as toxic diffuse goiter, is an autoimmune form of hyperthyroidism. The immune system creates antibodies known as thyroid-stimulating immunoglobulins. Creating an increase in thyroid production of T3 and T4 |
| Hyperthyroidism | increased levels of T3 and T4, most commonly due to Graves Disease |
| Hyperthyroidism S/S: | weight loss, heat intolerance, anxiety, palpitations, increased bowel frequency, insomnia, and menstrual abnormalities. |
| Hyperthyroidism DX: | serum TSH levels (1st test) |
| Hyperthyroidism | Complications: thyroid storm (acute life threatening form of thyrotoxicosis, way too much T3 & T4) heart rate, blood pressure, and body temperature danerously elevated |
| Hypothyroidism | decrease in T3 T4 |
| Hashimoto’s thyroiditis | autoimmune hypothyroidism. The most common cause of hypothyroidism. Elevated TSH because of low T3 T4 |
| Hashimoto’s thyroiditis S/S: | weakness, fatigue, cold intolerance, constipation, weight gain, depression, hair loss, menstrual irregularities, hoarseness. Dry, cold, puffy skin accompanied by edema, bradycardia and delayed relaxation of DTR’s(deep tendon reflex) |
| Hashimoto’s thyroiditis Dx: | serum TSH followed by free T4 levels |
| Hashimoto’s thyroiditis Tx: | for uncomplicated(hashimoto,) levothyroxine |
| Hashimoto’s thyroiditis Complications: | myxedema coma, decreased mental status, hypothermia |
| Parathyroid | PTH targets bone and kidney. Increases blood Ca, decreases urinary excretion. Osteoporosis can result from too much PTH. |
| Adrenal Cortex | GFR = Zona Glomerulosa, Zona Fasciculata, Zona Reticularis |
| Zona Glomerulosa | Produces aldosterone |
| Zona Fasciculata | Produces glucocorticoids |
| Zona Reticularis | Produces sex hormones, ex: estrogen |
| Hirsutism | a condition of unwanted, male-pattern hair growth in women. Hirsutism results in excessive amounts of dark, coarse hair on body areas where men typically grow hair — face, chest and back. |
| Ligament Treitz | ligament that connects the esophagus to the duodenum. The ligament denotes the border between upper and lower GI |
| Cachexia | loss of unintended weight, significant decrease in appetite, muscle atrophy, fatigue, weakness. Mostly as a complication of other diseases such as AIDS or Cancer. |
| Cryptosporidiosis | caused by the protozoa cryptosporidium, causing respiratory and gastric illness, primarily involving watery diarrhea. Most commonly isolated in patients with HIV. |
| BMI: Obesity = | >30 |
| Cholelithiasis | gallstones, biliary colic, that block the cystic duct. |
| Cholelithiasis S/S: | abdominal pain RUQ(may radiate to shoulder or subscapular area), dyspepsia, flatulence, nausea, vomiting |
| Cholelithiasis Risk factors: | 4F Female Fat Forty Fertile (pregnant) |
| Cholelithiasis DX: | RUQ ultrasound |
| Cholelithiasis TX: | if symptomatic= cholecystectomy, If asymptomatic= no tx required |
| Cholecystitis | acute or chronic inflammation of the GB usually from cholelithiasis. |
| Cholecystitis S/S: | RUQ pain, Fever , nausea, vomiting, Murphy’s sign. |
| Cholecystitis DX: | leukocytosis, Ultrasound(to look for stone, or bile sludge |
| Cholecystitis TX: | if severe, cholecystectomy using laparoscopy |
| Alcoholic hepatitis | AST:ALT ratio greater than 2:1 |
| Exocrine | digestive enzymes |
| Endocrine | hormone=insulin and Glucagon |
| Insulin | decreases blood glucose, increases glycogen, fat, and protein synthesis |
| Glucagon | increases blood glucose, decreases glycogen and fat metabolism |
| Glycogen | stored sugar energy |
| Pancreatitis | May be acute or chronic. Epigastric pain may radiate to back |
| Acute pancreatitis | autodigestion of pancreas by pancreatic enzymes. |
| Acute pancreatitis Causes | "Get Smashed" Get: Gallstones and ethanol make up 50% of cases Ethanol alc Trauma Smashed: Steroid, mumps, autoimmune dz, scorpion sting, hypercalcemia, hypertriglyceridemia (more than 1000), ERCP, drug (sulf drug) |
| Acute pancreatitis DX | Lab will reveal increased lipase, and possibly amylase |
| Chronic pancreatitis | Chronic inflammation, atrophy and calcification of the pancreas. There is no increase in lipase and amylase like there was in acute pancreatitis |
| Chronic pancreatitis Major cause: | Adult: alcohol; kids: cystic fibrosis |
| Chronic pancreatitis S/S | Triad = Diabetes mellitus + Steatorrhea (fat in stool) + pancreatic calcification on CT Scan Other: pancreatic insufficiency, fat soluble vitamin deficiency Increases risk for pancreatic adenocarcinoma |
| Pancreatic Adenocarcinoma | Pancreatic cancer 75% of cases found in the head of the pancreas |
| Pancreatic Adenocarcinoma S/S | abdominal pain radiating to back, obstructive jaundice, weight loss, migrating thrombophlebitis (trousseau sign), red, swollen, tender on palpation) painless jaundice and enlarged Gb |
| Pancreatic Adenocarcinoma TX: | |
| Diabetes Mellitus Type 1 | autoimmune pancreatic B Cell destruction leading to insulin deficiency and abnormal fuel metabolism. Failure to produce enough insulin, previously referred to as juvenile diabetes. |
| Diabetes Mellitus Type 1 acute complication | Sudden onset DKA/diabetic ketoacidosis (Signs and symptoms may include vomiting, abdominal pain, deep gasping breathing, increased urination, weakness, confusion, and occasionally loss of consciousness) |
| Diabetes Mellitus Type 2 | A dysfunction in glucose metabolism characterized by insulin resistance that may lead to B Cell burnout and insulin dependence. Previously referred to as adult onset diabetes. |
| Diabetes Mellitus Type 2 acute complication | hyperglycemic hyperosmolar state (high blood sugar causing dehydration, high osmolarity, coma, death) |
| Diabetes Mellitus Type 2 S/S | include signs of dehydration, weakness, legs cramps, trouble seeing, and an altered level of consciousness. |
| Diabetes Mellitus Type 2 medication | metformin |
| Diabetes Mellitus Type 2 complications | (macrovascular) atherosclerosis, coronary artery dz. (microvascular) retinopathy, nephropathy, neuropathy. Excess glucose stored in liver and muscles as glycogen. |
| Diabetes Mellitus Type 2 DX | A1c 6.5 or higher |
| Gastric ulcer | worse with food |
| Duodenal ulcer | better with food |
| Diverticulosis | Outpouchings of mucosa and submucosa that herniate through the colonic muscle layers in areas of high intraluminal pressure. Most commonly found in the sigmoid |
| Diverticulosis S/S | painless and sudden bleeding, generally presenting at hematochezia. Symptoms associated with anemia (fatigue, lightheadedness, dyspnea on exertion) |
| Diverticulosis risk factors | low fiber, high fat diet. Advanced age (over 80 yrs old makes up 65% of cases.) and CT disorders (eg Ehlers Danlos syndrome) |
| Diverticulosis DX | only diagnosable by colonoscopy, abdominal x ray, contrast CT. |
| Hematochezia | passing of fresh blood through the anus, with or without stools |
| Melena | dark, tarry, blood in stool indicating upper GI bleeding |
| Diverticulosis vs Diverticulitis | No pain Lower - left quadrant pain Bleeding fever, N/V leukocytosis, perforation |
| Diverticulitis | inflammation and potential perforation of the diverticulum, 2nd to fecalith impaction. |
| Diverticulitis S/S | Presents with LLQ pain, fever, N/V, constipation or diarrhea Serious condition can lead to peritonitis and shock |
| Diverticulitis DX | CBC may show leukocytosis. Abdominal x ray, colonoscopy, barium enema. Must avoid sigmoidoscopy/colonoscopy with early diverticulosis to avoid perforation. |
| Small bowel obstruction: (SBO) S/S | moderate-severe abdominal pain, copious emesis, cramping pain |
| Small bowel obstruction: Distal | moderate-severe abdominal pain, copious emesis, cramping pain. plus fever, signs of dehydration, and hypotension. |
| Small bowel obstruction DX | abdominal distention ( distal SBO) abdominal tenderness, visible peristaltic waves, fever, hypovolemia. Look for surgical scars/hernia. Rectal exam. Makes high pitched “tinkling” bowel sounds, later no sounds |
| Small bowel obstruction Etiology | in order of prevalence: adhesion post surgery(60%), Hernia, neoplasm, other(volvulus, intussusception, gallstones ileus, foreign body, crohns, cystic fibrosis, stricture, hematoma. |
| Partial SBO | flatulence continues but no stools |
| Complete SBO | no flatulence no stools |
| Eating disorders | anorexia and bulimia both can have purging and binge eating, but anorexia will have both amenorrhea and a low BMI (about 13) |
| UTI | Mostly in women. 80% of cases=E Coli |
| UTI Risk factors | catheters and other urologic instruments, anatomic abnormalities (BPH, vesicoureteral reflux). Previous UTI’s or pyelonephritis, diabetes M, recent antibiotic use, immunosuppression and pregnancy. |
| UTI S/S | dysuria, urgency, frequency, suprapubic pain, possible hematuria. |
| UTI in Children | bedwetting, poor feeding, recurrent fevers and foul smelling urine. |
| UTI DX | vaginitis, STD’s , urethritis, acute urethral syndrome, prostatitis |
| Infection causes of UTI’s | “SEEKS PP” Serratia, Ecoli, Enterobacter, Klebsiella pneumoniae, Staphylococcus saprophytous, Pseudomonas, Proteus Mirabilis |
| Nephrolithiasis | renal calculi/kidney stone |
| Nephrolithiasis S/S | Unilateral flank tenderness, flank pain may radiate to groin, nausea, vomiting, +/- hematochezia. NO FEVER |
| Nephrolithiasis complication | hydronephrosis, pyelonephritis. |
| Nephrolithiasis DX | (NON CONTRAST) CT Scan or KUB X Ray |
| Nephrolithiasis TX | treat and prevent by encouraging fluid intake |
| Cystoscopy | looks at bladder |
| Temporal Arteritis | due to subacute granulomatous inflammation of large vessels including aorta, external carotid artery(esp temporal branch) and vertebral arteries. |
| Temporal Arteritis | Most feared manifestation is blindness 2nd to occlusion if the central retinal artery (a branch of the internal carotid) |
| Temporal Arteritis Risk Factors | over 50 and female |
| Temporal Arteritis S/S | headache scalp pain and temporal tenderness, jaw claudication, fever, permanent monocular blindness, weight loss, myalgia, arthralgia (esp of shoulder and hip) |
| Temporal Arteritis DX | ESR over 50 (erythrocyte sedimentation rate, has to do with inflammation), ophthalmologic eval, temporal artery biopsy |
| Temporal Arteritis TX | high dose prednisone begun immediately to prevent blindness. |
| Hemophilia | Deficiency of clotting factor, X linked |
| Hemophilia Types | A: factor 8 deficiency (90%) B: factor 9 deficiency (9%) C: factor 11 deficiency (1%) |
| Von Willebrand DZ (vWD) | most common inherited bleeding disorder Autosomal dominant |
| Von Willebrand DZ (vWD) S/S | heavy menstrual bleeding, bleeding after minor injuries, bleeding gums. |
| Von Willebrand DZ (vWD) Tx | a bleeding episode is treated with DDAVP (desmopressin) |
| Thrombophlebitis migrans | blood clot occurring repeatedly in different locations, migrating indicated by the Trousseau sign of malignancy.can indicate pancreatic cancer |
| Hypertension | >140 systolic and or >90 diastolic measured 3xs at separate occasions. Classified as 1st or 2nd degree. |
| 1st degree (essential hypertension) (Idiopathic) | has no identifiable cause. 95% of hypertensive cases. |
| 1st degree (essential hypertension) Risk Factors | Family Hx of hypertension or heart disease, high sodium diet, smoking, obesity, race (Black more than white), advanced age. Asymptomatic until complications. |
| 1st degree (essential hypertension) | Must rule out brain(stroke, dementia), Eye (cotton wool exudates, hemorrhage), heart (left ventricle hypertrophy) and Kidney (proteinuria, chronic kidney Dz. Renal Bruits may signify renal artery stenosis as the cause. |
| 1st degree (essential hypertension) Tx | “ABCD”. ACE inhibitors or ARBs, Beta-blockers, CCBs, Diuretics. Thiazide diuretics, calcium channel blockers, and angiotensin converting enzyme inhibitors. |
| 2nd Degree hypertension | cause is known and can be any of “CHAPS” C ushing syndrome, H yperaldosteronism, A ortic cooptation, P heochromocytoma, S tenosis of renal arteries |
| Aortic Dissection | commonly associated with hypertension Asymmetric pulses and Bp measurements are indicative of aortic dissection |
| Aortic Dissection S/S | sudden tearing/ripping pain in: the anterior chest (ascending dissection) Interscapular back pain (descending dissection) |
| Abdominal Aortic Aneurysm | More than 50% dilation of aortic walls Usually asymptomatic, discovered incidentally. Pulsatile abdominal mass, or Abdominal bruits |
| Abdominal Aortic Aneurysm Dx | all men 65-75 with HX of smoking should be screened once by ultrasound for AAA |
| Abdominal Aortic Aneurysm Tx | <5cm = monitor, >5.5cm (abdominal), 6cm (thoracic) = surgical repair Symptomatic or ruptured aneurysm = emergency medical surgery |
| Apex of heart location | 5th ICS |
| B Cell | precursors to plasma cells, source of antibodies, helps w/immunity, comes from bone marrow, matures in bone marrow |
| T Cell | comes from bone marrow, matures in thymus |
| Incidence | Newly Dx #. Number of dz that allows us to determine probability of being diagnosed with a disease during a time. |
| Prevalence | The total # of existing cases. A measure of Dz that allows us to determine a person’s likelihood of having a Dz. |
| Morbidity | another term for illness. A person may have several comorbidities. |
| Mortality | another term for death. # of deaths due to a Dz divided by the total population. |
| Hepatitis C | mostly transmitted via blood. |
| Lyme Disease | caused by a spirochete, tick born disease |
| Lyme Disease 1st S/S | red rash bullseye (erythema chronicum migrans), flu like symptoms, +/- facial nerve palsy |
| Lyme Disease Later S/S | monoarthritis( large joints, migratory polyarthritis), cardiac (AV node block), neurologic (encephalopathy, facial nerve palsy, polyneuropathy) |
| Lyme Disease Tx | Doxycycline, ceftriaxone |
| Other tick borne dz | rocky mountain spotted fever, babesiosis |
| Rocky mountain fever | fever rash on palms/soles that spread to the trunk. |
| VAricella-Zoster virus (VSV) | causes 2 dz; varicella and herpes zoster. Transmission occurs via respiratory droplet or direct contact. |
| Chicken Pox (varicella) | Prodrome: malaise, fever, headache, myalgia. Occurs 24 hrs before onset of rash Pruritic lesions appear in crops over 2-3 days |
| Chicken Pox (varicella) | Evolve from red macules - grouped central vesicles - crusting over Patient has any and all of the stages at any time, over entire body Not on palms or soles of feet |
| Shingles (Zoster) | Virus lays dormant in the dorsal root ganglia. Lesions crop up on nerves dermatomal distribution |
| Shingles (Zoster) | Outbreaks = intense local pain, then arise with grouped blisters on an erythematous base If immunocompromised can lead to severe local Dz Older patients with severe zoster can develop postherpetic neuralgia |
| Herpes Simplex Virus | painful recurrent vesicular eruption of the mucocutaneous surface due to infection with HSV |
| Herpes Simplex Virus 1 | oral, labial |
| Herpes Simplex Virus 2 | genital lesions |
| Recurrent HSV 1 | (oral)common cold sore presenting with an erythematous base with a cluster of crusted vesicles. Triggered by sun or fever |
| Recurrent HSV 1 Prodromal S/S | tingling, burning pain, lymphadenopathy, fever, discomfort, malaise. |
| Recurrent HSV 2 | (genital) unilateral cluster of blisters on an erythematous base with less pain and systemic involvement then HSV 1 infection |
| HSV 1 & 2 Tx | oral or IV acyclovir |
| HIV | retrovirus that destroys CD4 and T lymphocytes |
| HIV 1st test | ELISA which can have a false positive due to high sensitivity and moderate specificity |
| HIV 2nd test | western blot. Low sensitivity, high specificity |
| AIDS | HIV infection + CD4 count of less than 200 + Aids defining illness |
| AIDS defining condition | Cytomegalovirus retinitis (with loss of vision) Pneumocystis jiroveci pneumonia Chronic intestinal cryptosporidiosis HIV related encephalopathy Mycobacterium TB (pulmonary or extrapulmonary) Invasive cervical cancer |
| Tuberculosis | fever, tachycardia chronic cough, bloody sputum, weakness, weight loss, swollen lymph nodes. |
| Mononucleosis | swollen neck, enlarged spleen(so avoid contact sports) Caused by EBV(epstein Barr virus) |
| Neuropathy | Dz of peripheral or autonomic or cranial nerves |
| Neuritis | inflammation of a nerve |
| Radiculopathy | Dz of spinal nerve root and nerves |
| Trigeminal Neuralgia | cranial nerve 5, stabbing pain |
| Thumb Dermatome | C6 |
| Nipple Dermatome | T4 |
| Umbilicus Dermatome | T10 |
| Knee Dermatome | L4 |
| Dorsum of foot Dermatome | L5 |
| Achilles tendon Dermatome | S1 |
| Perineum Dermatome | S2-4 |
| Bell's Palsy | a lower motor neuron lesion of cranial nerve 7 that causes ipsilateral facial paralysis on both the forehead, cheek and anterior 2/3 rds of the tongue. Complete destruction of the facial nucleus itself or its branchial efferent fibers. |
| Bell's Palsy | May involve inability to close eye on involved side. |
| Bell's Palsy Cause | May occur: idiopathically, as a complication of AIDS, lymes, sarcoidosis, tumors or Diabetes. 3x’s more likely to occur in pregnant women, 4x’s more likely in diabetics than those without. |
| Parkinson’s | a long-term idiopathic hypokinetic degenerative disorder of the central nervous system that mainly affects the motor system. |
| Parkinson’s | Begins after age 50-60 Attributable to dopamine depletion in the substantia nigra Characterized pathologically by lewy bodies (intraneural eosinophilic inclusions) |
| Parkinson’s S/S "PARTS" | “4 PaRTS” or “PARKINSONS” Postural instability Rigidity (cogwheeling) Tremors (pill rolling/resting tremor) Slowed movement (bradykinesia) |
| Parkinson's S/S "PARKINSONS" | “PARKINSON'S”= P ill rolling, A kinesia/bradykinesia, R idgidity, K yphoisis, I nstability, N eck/head tremor, S? , O culogyric crisis (fixation of eyes in upward direction) N ose tapping, S mall writing (micrographia) |
| Parkinson's Tx | Levodopa and carbidopa, both are dopamine precursors. “Levo”=amino acid that crosses the BBB. “Dopa”=precursor to dopamine. Carbidopa, blocks metabolism of levodopa in the periphery. |
| Essential Tremor | action tremor. Most common movement disorder. Tremors often temporarily are relieved with alcohol consumption. |
| Essential Tremor Tx | Medication = beta blockers |
| Multiple Sclerosis | Patients should avoid hot weather because it exacerbates their s/s |
| Meningitis S/S | high fever, neck stiffness, headache, altered mental state |
| Meningitis Dx | tests include kernig and brudzinski |
| Dyspareunia | painful sex |
| Endometritis | inflammation of the endometrium. Associated with retained products following delivery, miscarriage, or abortion of foreign bodies (ex: IUD) Promotes infection by bacterial flora from vagina or intestinal tract. |
| Endometritis S/S | fevers and chills |
| Endometriosis | functional endometrial tissue outside the uterus |
| Endometriosis | CYCLICAL pelvic pain, rectal pain, dysmenorrhea, dyspareunia, Chronic LB and pelvis pain Pain during or after sex |
| Endometriosis Dx | Confirmed by laparoscopy. |
| Endometriosis S/S | Lesions have a blue-black “raspberry” or dark brown “burned powder” appearance Ovaries may have Endometriomas : characteristic “chocolate cysts” |
| Adenomyosis | endometrial tissue in the Myometrium of the uterus NON CYCLICAL pain, menorrhagia and enlarged uterus (boggy and big) |
| Ectopic Pregnancy | Fertilized egg implants outside the uterus. Site of implantation is usually tubal. |
| Ectopic Pregnancy S/S | PAVE - Pain(abdominal), Ammenorrhea, Vaginal bleeding, Ectopic Pregnancy |
| Ectopic Pregnancy Dx | Approach all women with abdominal pain of reproductive age as if they might have ectopic pregnancy until proven otherwise. Pregnancy test with a transvaginal ultrasound revealing an empty uterus. Confirm with a serial hCG without appropriate HcG doubling. |
| Ectopic Pregnancy Tx | Medication Methotrexate is good for small unruptured pregnancy. Otherwise surgical options include: salpingectomy or salpingostomy with evacuation via laparoscopy/laparotomy if patient is hemodynamically unstable. |
| Ectopic Pregnancy Complications | tubal rupture hemoperitoneum which constitutes an obstetric emergency. |
| Uterine Leiomyoma Fibroids | Most common benign neoplasm in female genital tract Majority are asymptomatic |
| Uterine Leiomyoma Fibroids S/S | Mostly no symptoms Longer, heavier periods Pelvic pressure, bloating, constipation and rectal pressure, urinary frequency or retention Secondary dysmenorrhea, dyspareunia Firm nontender, irregular, englarged "lumpy bumpy" or cobblestone uterus. |
| Pre-eclampsia | hypertension and proteinuria plus edema |
| Preeclampsia Tx | delivery of fetus |
| Eclampsia | hypertension and proteinuria plus seizures. |
| Eclampsia Tx | delivery of fetus |
| Benign Prostatic Hyperplasia | Enlargement of the prostate that is a normal part of the aging process. Seen in more than 80% of men by age 80. Presents commonly above 50 years old. |
| Benign Prostatic Hyperplasia S/S | Obstructive symptoms: hesitancy, weak stream, intermittent stream, incomplete emptying, urinary retention, bladder fullness. Irritative symptoms: Nocturia, daytime frequency, urgency incontinence, opening hematuria. |
| Benign Prostatic Hyperplasia Dx | DRE (Digital rectal exam) the prostate is uniformly enlarged with rubbery texture. If prostate is hard and or has irregular lesions, cancer should be suspected. Hx and Exam. Check UA for infection or hematuria, both of which should prompt further eval. |
| Benign Prostatic Hyperplasia Tx | terazosin (alpha-1 beta blocker), Finasteride(5alpha-reductase inhibitor), TURP (transurethral resection of the prostate. ) |
| Prostate Cancer | most common incidence, and 2nd leading cause of cancer death in men. |
| Prostate Cancer S/S | usually asymptomatic, but may present with obstructive urinary symptoms, lymphedema due to obstructive metastasis, constitutional s/s, back pain due to bone metastasis. |
| Prostate Cancer Risk Factors | advanced age and family hx |
| Prostate Cancer Dx | DRE may reveal a palpable nodule or area of induration. Early, usually not detectable on visual exam. Marked increase in PSA (above 4 mg/ml) The definitive Dx comes from Ultrasound guided transrectal biopsy. |
| Prostate Cancer Prevention | DRE for all males above 50 years old |
| Fitzpatrick scale | scale predicting skin cancer probability based on skin color |
| Goniometer | used to measure ROM |
| Inclinometer | used to measure ROM |
| McBurney’s point | appendicitis |
| Murphy’s sign | Positive result = cholecystitis. Palpation of gb area makes the patient hold their breath while wincing in pain |
| Trousseau Sign | migratory blood clotting indicative of either pancreatic, gastric or lung cancer |
| Asymmetric pulses and Bp measurements | are indicative of aortic dissection |
| Courvoisier’s law | if painless enlarged GB and painless mild jaundice then, not cholelithiasis, but potentially malignancy of the gallbladder or pancreas. |
| Tinel sign | pain when striking the median nerve confirms carpal tunnel |
| Phalen’s sign | if pain when holding hands in reverse prayer position, held for 30-60 sec, then a positive sign of carpal tunnel. Reverse phalen’s is same test but with prayer hands. |
| Kernig's sign | positive when the thigh is flexed at the hip and knee at 90 degree angles, and subsequent extension in the knee(beyond 130 degrees) is painful (leading to resistance). Indicates either meningitis, or subarachnoid hemorrhage. |
| Brudzinski | doctor bending the neck forward, makes the patient brings up knee. Sign for meningitis |
| Ankle jerk reflex (Achilles reflex) | Achilles tendon is tapped while foot is dorsiflexed. Tests function of the gastrocnemius muscle and the nerve that supplies it. A positive result would be the jerking of the foot towards its plantar surface. Confirms nerve emerging from S1, is working. |
| McMurray test | test for meniscus tear |
| Drop arm test | tests for supraspinatus rotator cuff tea |
| Hawkins kennedy | rotator cuff |
| Apprehension test | rotator cuff |
| Yergason's test | bicipital tenosynovitis |
| Speed test | bicipital tenosynovitis |
| Urea breath test | used to DX H.pylori infection |
| Sweat test | measures the amount of salt in the skin. Useful in dx cystic fibrosis. |
| (used 1st)ELISA and (2nd)Western Blot test | HIV test |
| TSH blood test | best test for screening/assessing thyroid function |
| OTC pregnancy test | measures hCG(human chorionic gonadotropin) that comes from placenta. It maintains the corpus luteum for the 1st trimester, eventually placenta takes over. Low, or slowly increasing hCG can suggest a miscarriage. |
| Creatinine | creatine is a byproduct of muscle metabolism removed from blood via GFR in Kidneys |
| DEXA/DXA Scan | evaluates bone density. |
| UT Scan | Pulses of high-frequency ultrasound, generally above one megahertz, are created by a piezoelectric transducer and directed into the body. |
| CT Scan | combines series of X-ray images from different angles around body and uses computer processing to create cross-sectional images (slices) of the bones, blood vessels and soft tissues inside your body. calcification of pancreas, most amount of radiation |
| Xray | a type of radiation called electromagnetic waves. X-ray imaging creates pictures of the inside of your body |
| Biopsy | an examination of tissue removed from a living body to discover the presence, cause, or extent of a disease. |
| Cystoscopy | looks at bladder |
| Bronchoscopy | views the airway |
| Endoscopy | looks for upper GI bleeding going as far as the duodenum |
| Colonoscopy | looks at lower GI |
| KUB X RAY | Kidney ureter and bladder imaging |
| Cholecystectomy | surgical removal of the gallbladder. |
| pancreaticoduodenectomy (Whipple Procedure) | surgery to remove pancreatic tumors |
| Cholelithiasis | RUQ |
| Appendicitis | RLQ |
| Diverticulitis | LLQ |
| Ovarian torsion, ectopic pregnancy | RLQ and/or LLQ |
| Cholelithiasis | RUQ to shoulder/subscapular area |
| Nephrolithiasis | flank to groin |
| Abdominal aortic aneurysm | abdominal to back |
| Appendicitis | periumbilical to McBurney’s point |
| Pancreatic adenocarcinoma | abdominal pain radiating to back |
| Cytochrome P450 | major enzyme responsible for drug metabolism |
| Cytochrome P450 Inducer | decreases drug effect by increasing metabolism (st john's wort) |
| Cytochrome P450 Inhibitor | increases drug effect by decreasing metabolism of drug (grapefruit) |
| Statins: ex | imvastatin, atorvastatin, pravastatin |
| Statins Adverse side effects | myalgia (so don't take with grapefruit juice, a cytochrome inhibitor). This happens because statins block the coenzyme Q10 |
| Lasix(furosemide ) | a diuretic can deplete potassium. Can also cause tinnitus |
| Finasteride (Proscar) | benign prostatic hyperplasia and male pattern baldness. Includes 5a reductase inhibitor, prevents testosterone from converting to DHT which enlarges the prostate. Medication can produce false negative test for prostatic cancer because of this |
| First generation antihistamines | Diphenhydramine (benadryl) have a side effect of drowsiness |
| Second generation antihistamines | Cetirizine (zyrtec) claritin. Side effect: minimal toxicity |
| Aspirin (Salicylate) overdose S/S | tinnitus, nausea, high temp., and hyperventilation |
| Corticosteroids | long term results in s/s of cushing's syndrome, hirsutism and abdominal striae |
| Antifungal drugs | end in -azole |
| Fat soluble vitamins | A,D,E,K |
| Water soluble vitamins | B,C |
| Antioxidants | A,C,E |
| Vitamin E Toxicity | causes easy bruising….also nausea, gastric distress, abdominal cramps, diarrhea, headache, fatigue. Inhibits platelet aggregation. Muscle weakness. Creatinine urea |
| Carotenemia | S/S yellow skin on palms and feet, but not sclera (jaundice has sclera that are yellow) all from too much carotene. |
| Pellagra | Vitamin B3 deficiency (niacin) |
| Pellagra S/S | 4D's - Diarrhea, Dermatitis, Dementia, Death |
| Neurofibroma | type of nerve tumor that forms soft bumps on or under the skin |
| Cheyne stokes | Abnormal pattern of breathing characterized by progressively deeper, sometimes faster, breathing followed by a gradual decrease that results in a temporary stop in breathing called an apnea. Pattern repeats |
| Drugs that cause constricted pupils | Heroin, Morphine, Opiates (Oxycodone, Fentanyl), Methadone, Codeine, Hydrocodone |
| Drugs that cause red eyes | Marijuana, Cocaine or Crack, Benzodiazepines (Xanax), Depressants (alcohol or sedatives) |
| Drugs that cause dilated pupils | Amphetamines, Methamphetamines, Cocaine or Crack, Hullucinogens (LSD or mushrooms), Marijuana, Speed |
| Which Hepatitis has a vaccine | A |
| Hep. E mode of transmission | food/fecal |
| Hep. A mode of transmission | food/fecal |
| Hep. B mode of transmission | Blood |
| Informed consent includes | Risk of treatment, treatment procedures, alternative to treatment |
| First sign of Mono. | severe sore throat |
| Do what first when a person faints | check for responsiveness |
| One required to make Diabetes M. diagnosis | 1. Fasting plasma glucose >126, 2 occasions 2. Radom plasm glucose >200 plus symptoms 3. 2 hour postprandial glucose >200, 2 separate occasions 4. HbA1c 6.5% or higher |
| Secondary hypertension causes | Cushing's syndrome, Conn's syndrome, pheochromocytoma |
| CN lesion of Bell's Palsy | CN VII Facial, lower motor neuron lesion |
| Most common cause of acute lower GI bleeding in patients over 40 years old. | DiverticulOSIS |
| Cytoscope | Flexible and rigid, look at bladder |
| BMI:Overweight | >25 |
| BUN | reveal kidney function. The liver makes urea as a waste product of protein, which makes blood urea nitrogen (BUN). |
| Cranial nerve for balance | VIII |
| Pernicious Anemia | Cobalamin, Vitamin b12 def. |
| Wernicke-KorsaKoff disease | thiamine, vitamin B1 def. Neurological condition: confusion, problems with voluntary movements, eye abnormalities. Thiamine helps in the processing of glucose |
| Medication for KD stones and chronic gout | Allopurinol |
| Cause of SOB in children | hernia |
| MOA of Warfarin (Coumadin) | Inhibits synthesis of Vit. K |
| Hormone that increases Calcium levels in blood | PTH |
| Adrenal medulla hormones | epinephrine, norepinephrine (adrenaline) |
| Diameter 3cm | Stone can be treated with ESWL, percutaneous nephrolithotomy, retrograd ureterscopy |
| 3 Levels of Meninges | protective tissue called the dura mater, arachnoid mater, and pia mater that surround the neuraxis. The meninges of the brain and spinal cord are continuous, being linked through the magnum foramen. |
| RAAS | renin-angiotensin-aldosterone system, plays an important role in regulating blood volume and systemic vascular resistance, which together influence cardiac output and arterial pressure. Renin - kidneys, Agt. - blood & tissues, Ald. - adrenal cortex |
| ACE | Angiotensin-converting enzyme |
| Which organ/organs releases ACE | Lungs & kidneys |
| What do ACE inhibiters intercept | ACE (Angiotensin-converting enzyme) |
| Hormone high in menopause | FSH |
| Hormone high in galactorrhea | Prolactin |
| Negative feedback loop with birth control pills (Estrogen and Progesterone or just Progesterone) | 1st - suppression of gonadotropins, 2nd (FSH,LH) through - feedback inhibition, 3rd inhibition prevents rise in FSH (necessary to trigger ovulation) |
| Which hormone increases during ovulation | Progesterone |
| Constricts pupils | Parasympathetic nervous system |
| CN VII | (facial nerve) Innervates anterior 2/3 of tongue |
| CN IX | (glossopharyngeal) innervates posterior 1/3 of tongue |
| Cerebellum | controls muscle tone, balance, coordination and is involved in speech |
| Arachnoid villi | absorb excess CSF |
| 2 most common cause of kidney failure | type 2 diabetes and hypertension |
| Types of COPD | Asthma, emphysema, chronic bronchitis |
| Blue bloater type COPD | Daily productive cough for three months or more in at least 2 consecutive years Overweight and cyanotic Elevated hemoglobin Peripheral edema Rhonchi (crackles) and wheezing Purulent sputum CO2 retention (Insensitive to it) |
| Pink puffer type COPD | Permanent enlargement and destruction of airspaces distal to terminal bronchiole Older and thin Severe dyspnea Quiet chest Barrel chest X-ray: hyperinflation w/flattened diaphragms Pursed-lip breathing Cachectic appearance Minimal cough CO2 ok |
| Chlamydia (most common STD) can cause | Pelvic inflammatory disease (PID) |
| Cluster headaches | Circation periodicity; unilateral and orbital head pain; can be recurring or remission; sweating, swelling, tearing, runny nose . |
| Meningitis headaches | Neck stiffness or meningismus; fever; severe "splitting"; Nausea/vomiting; sensitivity to light |
| Differentiate between histamine headache and cluster headache | Histamine headaches are cluster headaches caused by either a release of histamine or ingestion of histamines |
| Refer to ER | Meningitis |
| Differentiate between Wernicke's Encephalitis (usually occurs in alcoholics) and meningitis | Inflammation of the meninges, the membranes that surround the brain and spinal cord, is called meningitis; inflammation of the brain itself is called encephalitis. |
| When do Wernicke's Encephalitis and meningitis occur together? | Myelitis refers to inflammation of the spinal cord. When both the brain and the spinal cord are involved, the condition is called encephalomyelitis |
| Temporal arteritis headache | in the temple, behind the eye, severe. Jaw pain and potentially shoulder and hip pain |
| Fainting from hyponatremic hypotension | Mild cases are asymptomatic. The common symptoms include: Loss of energy Nausea and vomiting Confusion Muscle spasms Low blood pressure Dark scanty urine Irritability, disorientation and neurological manifestations Convulsions |
| Strep can cause | acute glomerulonephritis |
| ______sided heart failure can be associated with distended jugular veins | Right |
| Hiatal hernia causes and S/s | primarily attributed to gastroesophageal reflux disease (GERD) Symptoms: Heartburn Bitter or sour taste in the mouth or throat Stomach pain Severe chest or abdominal pain w/ nausea and/or vomiting, and no bowel movements or pass gas (needs ER) |
| Hiatal Hernia | Weakened muscle tissues make the stomach bulge and push through the diaphragm |
| Hiatal Hernia risk factors | Ageing, weakened diaphragm, large hiatus opening, increased abdominal pressure bc of pregnancy, obesity, severe cough, or straining during bowel movements, frequent vomiting or coughing, ascites or abnormal collection of fluid in the abdomen |
| Left-Hemisphere controls | Movement of the right side of the body Verbal language Numerical skills Written language Reasoning Scientific functions |
| Left-Hemisphere stroke effects | Paralysis(hemiplegia) on R side of body Aphasia - speech & language problems Memory problems - shortened attention span, difficulty learning new info. Problems w/concept & generalization Development of slow & cautious behavioral style |
| Right-Hemisphere controls | Movement of left side of body Perceptual tasks - judging distance, size, speed or position or seeing how parts are connected to wholes |
| Right-Hemisphere stroke effects | Left hemiplegia Spatial and perceptual problems - misjudge distances Can't tell right-side-up from upside down Judgment and impulse problems Left-side "neglect", "forgetting" or "ignoring" things on left side Bad short-term memory |
| S/S of ulcerative colitis | Bloody, sticky diarrhea, abdominal pain |
| S/S of scabies on the hands | Itchy web on skin of fingers, tunnels and burrows on hands |
| Measles | little white cluisters in cheek (koplik spots) and red patches on face and body |
| Inflammatory breast cancer | Dimples around nipple with redness and an orange peel look, no enlarged lymph nodes in axillae and no pain |
| Young 3 year old with sudden wheezing and no other symptoms | Can have aspiration of foreign body |
| Patient with big belly, who gains weight and has hirsutism indicates | Cushing's syndrome |
| Meniere's Dz | triad: tinnitus, monaural (one ear) fullness, fluctuating hearing loss and episodic vertigo that lasts 2 hours |
| Benign paroxysmal positional vertigo | lasts a few seconds, not hours |
| Vestibular neuritis | Affects the labyrinth and a has different pattern than 2 hours of vertigo without hearing impairment. |
| Raynaud's Dz | spasm of arteries cause episodes of reduced blood flow. white-blue-red |
| Reye's Syndrome | Swelling of brain and liver. Can be induced in children given aspiring, during the chicken pox or flu. |
| Reye's Syndrome S/S | Hx of flu/chicken pox, child. Heavy vomiting Fatty liver Delirium coma Can be life threatening |
| Best diagnostic exam for heartburn | Endoscopy |
| Occult blood test examines | the stool |
| DEXA tests for | Bone density |
| Best imaging for soft tissue | MRI |
| Best cost effective test for DVT | D'Dimer |
| DVT | Deep vein thrombosis, blood clot forms in a vein deep in the body. Usually lower leg or thigh. |
| Best imaging test for cranial fracture or subdural bleed | CT or flat plate x-ray |
| Barium enema screens for | Colon cancer |
| CPK (Creatine phosphokinase) and troponin levels indicate | MI/Heart attack |
| ESR can help Dx | Temporal arteritis and inflammation |
| ESR (erythrocyte sedimentation rate) | Blood test that measures how quickly erythrocytes (red blood cells) settle at the bottom of a test tube that contains a blood sample. Faster-than-normal rate may indicate inflammation in the body. |
| Other names of ESR | Sed rate (sedimentation rate) and Westergren sedimentation rate |
| ACE inhibitors | Vasodilates to lower blood pressure in tx of CHF and hypertension, -april |
| CA channel blockers | Dilate arteries and lower the pumping power of the heart, -ipine |
| Beta blockers | Block effects of the hormone epinephrine, also known as adrenaline. Heart beats slower and with less force, thereby reducing blood pressure, -olol |
| Coq10 prescribed for | Patients taking statins |
| Statins prescribed for | High cholesterol |
| Muscle most likely injured when a person falls and injures rotator cuff, | Supraspinatus |
| Numbness of thumb and index finger with decreased bicep tendon reflex involves spinal segment | C6 |
| Sitting for a long time can affect | Piriformis muscle |
| Pain between 3rd and 4th toe can be | Morton's neuroma |
| Flexing leg 90 degrees of a patient prone with pressure on the ankle and rotation of the knee tests for | Meniscus tear |
| Trendelenburg test assesses for | Weak medial gluteus |
| Selenium is a mineral that also works as an | Antioxidant obtained through diet Metabolism and thyroid function Reduce oxidative stress, keeps free radical numbers in check Reduce risk of certain cancers Protect against heart disease Prevent mental decline Boosts immune system Help Asthma |
| Excess intake of Vit A or B3(nicacin) | Can damage the liver |
| Vitamin C helps | Absorb iron |
| Vitamin K def. can lead to | Easy bruising, bleeding and bone mineral loss |
| Best diet for kidney disease | Low nitrate, low potassium, low phosphorus DASH Diet - rich in fruits, vegetables, low-fat dairy products, whole grains, fish, poultry, beans, seeds, and nuts. It is low in salt and sodium, added sugars and sweets, fat and red meats. |
| Diet high in fat and low in carbs causes | Ketosis/ketoacidosis |
| What do you do with a pneumothorax patient (cough, SOB after needling) and you have called the ambulance | Watch closely and wait for ambulance |
| If treating a child and notice bruises | Call child protective services immediately and directly. Do not just tell your supervisor. |
| Patient authorization needed to release psychiatric notes unless patient is | Incapacitated |
| HIPAA (Health Insurance Portability and Accountability Act) | Created national standards to protect a patient's identifiable information in healht records. Allows patient greater access to their own records. |
| FERPA (Federal Eucation Rights and Privacy Act) | Similar to HIPAA, but applies to the school setting and defines access to and protects the educational record of a student, including a school health record. |
| Minors have a right not to disclose medical notes to parents after a certain age | 18. unless state laws allow a younger age and at the discretion of medical provider. |
| If father wants 16 year old kids medical records they can be released to him except… | Adults cannot access child's medical records related to STDs, abortion or birth control |
| Medical records of patients are owned by | Practitioner, not the hospital or patient |
| Which employees in your clinic need blood borne pathogen education | Anyone at risk of coming into contact with blood. |
| Shoulder limited ROM in passive and active tests, limiting activities of bathing/brushing hair, but not much pain in ROM tests. | Frozen Shoulder/Adhesive capsulitis |
| Frozen shoulder/Adhesive capsulitis | Dull or aching pain in outer shoulder area. Pain sometimes in upper arm Stiffness or restricted motion 3 Stages: Freezing (acute pain), Frozen (less pain), Thawing (increased ROM) |
| Rotator cuff tear | Pain at rest and at night, esp. if lying on affected shoulder Pain when lifting and lowering arm or specific movements Weakness when lifting or rotating arm Crepitus or crackling sensation when moving shoulder in certain positions |
| Dynamometer | Tests strength when diagnosing rotator cuff injuries |
| Bicipital tenosynovitis | Inflammation of the tendon and sheath lining of the biceps muscle Pain or tenderness front of the shoulder, worsens with overhead lifting or activity Pain or achiness that moves down the upper arm bone Snapping sound or sensation in shoulder |
| Falling off ladder leading to lower limb nerve stuff-paralysis and loss of BL/bowel fnx. | Vertebral fracture T11/T12 |
| Guillian-Barre Syndrome | Rare disorder Immune system attacks nerve cells Weakness, numbness and tingling in extremities usually first symptoms Sensations can quickly spread, paralyzing whole body Exact cause unknown Usually appears after Resp. or Digst. tract infection |
| What is most important on an intake form from a public health perspective: occupation/travel history or age/gender | Age/gender |
| Winged scapula, what muscle/s affected | Long thoracic nerve - Serratus Anterior Dorsal scapular nerve - Rhomboid Spinal accessory nerve - Traps |
| 2 types erectile dysfunction | Organic and phychogenic |
| What might be indicated with long term low grade fever | Malignancy |
| GYN symptoms of pain, etc. when several courses of antibiotics did not work | Possibly PID (Pelvic inflammatory disease) |
| PCOS (Polycystic ovary syndrome) | Infrequent, irregular, or prolonged periods Excess male hormone (androgen) Hormonal disorder common among women of reproductive age |
| PID (Pelvic inflammatory disease) | Occurs when sexually transmitted bacteria spread from the vagina to the womb, fallopian tubes or ovaries. Often caused by Chlamydia |
| PID S/S | Pelvic pain Fever and chills Vaginal discharge Pain in lower abdomen Pain during sex Abnormal uterine bleeding Difficulty urinating |
| PID Tx | Antibiotics Possibly surgery if not treated immediately |
| More useful/accurate test for blood sugar long term | Hb A1c |
| Acupuncture practitioner practicing w/ HIV | HBV - You can practice once appearing in front of a board who ensures you know best practices for managing condition in clinic setting |
| Tardive Dyskinesia + another symptom are side effects of what kind of drug | Antipsychotics |
| Tardive Dyskinesia | Serious side effect that may occur with certain medications used to treat mental illness. TD may appear as repetitive, jerking movements that occur in the face, neck, and tongue |
| What type of anemia is sickle cell | Hemolytic |
| Addison's disease | Primarily due to deficiency of cortisol and aldosterone. Weak muscles Decreased heart rate Darkening of the skin (hyperpigmentation) |
| Cushing's syndrome | High levels of cortisol Rise in hormone levels could be due to increased production of cortisol or overuse of corticosteroids S/S: Hump between shoulders (Buffalo hump) Round face (Moon face) Purple stretch marks on the skin Weight gain |
| Thryroid storm | Occurs as a result of untreated or undertreated hyperthyroidism. Characterized by increased heart rate, restlessness, persistent sweating, and loss of consciousness, nausea and abdominal pain. And other hyperthyroid S/S such as exophthalmos |
| Exophthalmos (exophthalmus, exophthalmia, proptosis, or exorbitism) | A bulging of the eye anteriorly out of the orbit Can be either bilateral or unilateral |
| Cutting Maneuver | Sidestep then quick change in direction. 70% of ACL injuries |
| Niacin toxicity S/S | Severe skin flushing combined w/dizziness Rapid heartbeat Itching Nausea and vomiting Abdominal pain Diarrhea Gout |
| Deficiency with nerve damage. | B12 Needed for myelin sheath |
| Megaloblastic anemia | Known as these anemias: B12 Folate deficiency Macrocytic |
| B12 and Cobalamin deficiency | Pernicious Anemia |
| Pulsatile mass lateral to umbilicus | AAA (Anterior Aortic Aneurysm) |
| What imaging/enema/test for diverticulosis | colonoscopy abdominal CT/Barium Enema (which is a contrast type of Xray) |
| Test for venous thrombosis | Doppler CT |
| Risk factors for blood clots | Cancer HIV Vit K excess Smoking birth control pills sedentary trauma surgery |
| Fainting cause for a teenage girl standing for 2 hours during a choir rehearsal | Vasovagal syncope Fainting caused by nerve impulses that slow heart rate Also possibly low blood sugar |
| Elem school teacher, rash pustules | Chicken pox |
| HIPAA - email | The Privacy Rule allows covered health care providers to communicate electronically, such as through email, with their patients, provided they apply reasonable safeguards when doing so. |
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