Question | Answer |
Mc Burrney Point | RLQ pain - appendicitis (w/rebound tenderness), watch for peritonitis
LLQ pain - diverticulitus |
Koplick Spots | Red spots w/blue center (usually in mouth
-MEASLES |
Turners Sign | Flank grayish blue - Pancreatitis |
Cullens Sign | Echmosis in umbilical area - Pancreatitis |
Kernings Sign | Pt. supine, w/hip flexed 90 degrees, can't fully extend - Mennigitis |
Brudzinski's Sign | Passive Flexion of neck causes flexion of both thighs -Menningitis |
Caput succinidanium (cephalhemotoma) | Resolves on its own in a few days. Due to edema crosses the suture lines. |
SNS | Flight or Fight- Increases BP, HR, RR and Decreases GI, UO also dilated pupils (blurry vision), dry mouth, constricted blood vessels . Due to increased Ach. Activated by Anticholenergic drugs. |
Chest tube w/ HVac | Continuous bubbling in H20 chamber - AIR LEAK
H20 seal chamber should bubble w/ inspiration- Normal
Continuious Bubbling in suction chamber- Normal
up and down in H20 chamber -Normal |
PNS | Rest and Digest - decreased HR, constricted pupils, relaxed, increased sex drive, warm dry skin. Due to decreased Ach, inhibited by Anticholenergic drugs. |
ANP (Think A~N~P, like A hearts P, get rid of N) | Excretes Na and H20 in vascular space when heart is streched. Works on kidneys. Opposite of Aldosterone. |
Aldosterone (holds on to lots of letters) | Retains Na and H20 in vascular space. Opposite of ANP.
Increased = Cushings (FVO)
Decreased = Addison's (FVD-shock) |
ADH (think AD is holding on to H, or AD H) | Retains H20 in vascular space.
Cause- any head/pituitary problem that can lead to increased ICP.
Increased= SIADH (too many letters too much water)
Decreased = DI (poss Shock) |
TIA | Mini stoke from small blood clots causing sx of stock but only lasts 24 hours. NO DEAD BRAIN TISSUE. Asa is ok
Sx: sudden decrease in LOC, blurred vision, HA, slurred speech |
CVA | Stoke. DEAD BRAIN TISSUE. Most imp to take meds regularly, HTN can increase risk. Before 1st meal check gag reflex. (If in R hem increased risk accident, disorientated, poor judgement, impulsive) |
Stoke | Sudden LOC due to rupture or occlusion of blood vessel leads to decreased O2 to brain |
CUSHINGS TRIAD | -INCREASED BP
-DECREASED P & R
r/t ICP (shock is opposite) |
Hypoxia | Sx: **Restless and Confused**, cynosis, Increased P and R
Labs: Inc H&H and RBC
Tx: manually vent w/ 100% O2
Fetal Hypoxia - cord prolapse, shows w/ late decels. Give mom O2 |
Nephrotic Syndrome | Sx: ** Massive Protein Uria**, edema and hypotension
Cause: glomerial damage
Tx: corticosteroids, turn and reposition (rsk skin integrity) |
Glomerulonephritis | **Infection to strep 1st**
Sx: decreased appitite and Increased fatigue
Tx: takke vs q 4 hrs (BP), daily weight, diet restrictions-Na,K, protein and fluid
Dx: Increased ASO titer |
Rheumatic Fever | **Group A Strep 1st-Fever**
Sx: Chorea (grimacing, sudden body movements), joint pain
Rsk: can lead to HF and Mitral Stenosis
Dx: Increased ASO titer
Tx: Penicillin |
MS | Chronic progressive dz, demylenating lesions in CNS.
Sx: hyperactive DTR, limb weakness, fatigue, spacity, numbness, tingling, tinnitus, visual changes, paralysis |
CF | Autosomal Recessive (both parents)- causes sticky mucus to build up in lungs, digestive tract
Sx: **meconium illius at birth**, inconsolable, doesn't eat, not passing meconium, salty skin.
Tx: fat soluble (ADEK), decrease fat, increase Na & mucomyst |
Kawasaki Syndrome | Inflammation of blood vessels, can lead to heart problems)
Sx: STRAWBERRY TONGUE |
Gillian Barre Syndrome | Bodys immune system attacks nervous system leading to nerve inflammation.
Sx: ASCENDING PARALYSIS, watch R sx |
Fetal Alcohol Syndrome | Upturned nose, flat nasal bridge, thin upper lip, SGA
Irritability, poor sucking, hypotonicity |
Narcotic Withdrawal Syndrome | Hyperactivity, Irritability, Poor Sucking, High Pitched Cry |
Asthma | WHEEZING ON EXPIRATION, or coughing w/o sx |
Nephrotic Syndrome | -Proteinuria
-Decreased protein in blood
-Increased Cho
-Increased Tri
Edema and Decreased BP |
TEF | 4 C's (coughing, choking, cynosis, continus drooling) |
Basilar Fracture | BATTLE SIGN (bruising behind ear) and OTTORHEA (discharge from ear)
-Skull fx at base |
Hepatic Encephlophy | FLAPPING TREMORS (tremor in hand when wrist is extended)
-Brain disorder caused by chronic liver failure |
UC | RECURRENT BLOODY DIARRHEA
-IBD affects lining of lg intestine and rectum |
Orbital Fracture | RACOON EYES |
Pernicious Anemia | BEEFY RED TONGUE, pallor, tachycardia, Increased R
Dx: Shillings test and Decreased RBC, plts, Hgb
Tx: B12 taken for life, risk of injury |
Parkinson's | PILL ROLLING TREMORS |
NMS (think S &M) | HOT (hyperpyrexia)
STIFF (increase muscle tone)
SWEATY
BP, R, P all Increase
DROOLING |
SIADH | Too many letters, TOO MUCH WATER
Caused by Increased ADH
SX: Changes in LOC, Increased HR and SG, Decreased Na and DTR, N/V and HA
Tx: Diuretics |
Cor Pulmonae | R side HF do do L ventricular failure.
**PICK EDEMA or JVD**
Sx: FVO, occurs in COPD (bronchitis or emphysema) |
Hypoglycemia | TREMBLING & HA |
SHINGLES | ADULT W/ RASH/BLISTERS ON 1 SIDE ONLY |
MENINGITIS | HA & STIFF NECK |
TB | NIGHT SWEATS
AFTERNOON FEVER
COUGH
WEIGHT LOSS
FATIGUE |
CHRONS | D & ABD PAIN |
GASTRIC ULCER | 30-60 MIN AFTER EATING |
DUODENAL ULCER | 1.5-3 HRS AFTER EATING
AWAKENS AT NIGHT
FOOD HELPS |
PEPTIC ULCER | COFFEE GROUND EMESIS |
PLACENTA PREVIA | NO PAIN & + BLEEDING
(think PP no P but Pink) |
PLACENTA ABRUPTION | PAIN & NO BLEEDING
(think PA=pain) |
HYPOVOLEMIA=DOWN | Increased T, R, P (weak), SG
Decreased BP
ANXIETY |
HYPERVOLEMIA=UP | BOUNDING P , HTN
DECREASED SG
CRACKLES/RALES & PERIPHERAL EDEMA
Tx: Semi- Fowlers |
PNA | RUSTY SPUTUM, FEVER, CONFUSION, crackles, hypoxia (worse)
Tx: sick side UP |
MEASLES | KOPLICK SPOTS (red with white/blue spots in mouth) |
PERNICIOUS ANEMIA | RED BEEFY TONGUE |
MENINGITIS | -BRUDZINSKI SIGN (neck flex=lower leg flex)
-KERNIG'S SIGN (leg flex then pain on extension)
-TRIAD (HA, light sensitivity, stiff neck)
Droplet = bacterial (CSF cloudy)
Standard = Viral (CSF clear) |
DVT | HOMAN SIGN (pushing on ankle and pain felt in calf) |
TETANY | HYPOCALCEMIA
Sharp flexion of wrists and joints
TROUSSEAUS SIGN (tremor in hand w. BP cuff)
CHEVOSTEK SIGN (facial spams, touch cheek) |
CHARCOTS TRIAD | JAUNDICE
FEVER
URQ PAIN
Dx: MS |
ANGINA | CRUSHING PAIN
-Relieved by NTG
-NO dead tissue |
MI | CRUSHING, STABBING PAIN that RADIATES ARMS, SHOULDER, NECK, BACK
-NOT relieved by NTG
-DEAD TISSUE |
EPIGLOTTIS | 3 D'S
-DROOLING
-DYSPHONIA (voice disorder)
-DYSPHAGIA (difficulty swallowing) |
RETINAL DETACHMENT | -VISUAL FLOATERS
-FLASHES OF LIGHT
-LOSS PORTION OF VISUAL FIELD |
BLADDER CANCER | PAINLESS HEMATURIA |
INCREASED ICP | CUSHINGS TRIAD
-INCREASED BP
-DECREASED P and R
agitation and dilated pupils |
SHOCK | -DECREASED BP (loss of fluid)
-INCREASED P &R |
WHAT ARE THE 2 SIGNS IN HYPOCALCEMIA | CHEVOSTK & TROSSEAU |
MENIERS DZ | -VERTIGO
-TINNITIUS
-N/V
(inner ear disorder affecting balance)
Tx: diuretics, Decrease Na, lay on affected ear |
PE | -***1ST sx SUDDEN CHEST PAIN***
-DYSPNEA AND TACHYPNEA |
CF | SALTY SKIN (lots of mucus -autosomal recessive) |
CHF in INFANT | -***TACHYCARDIA 1ST ***
- COUGH |
MENNIGIEAL IRRITATION | -HA
-PHOTOPHOBIA (sensitivity to bright light)
-NUCHAL RIGIDITY (stiff neck)
Dx: MENINGITIS and subarachnoid hemorrhage |
FAT EMBOLI | -PETECHAIE
Tx: Heparin |
PANCREATITIS | -CULLEN'S SIGN (bruising at umbilicus)
-GREY TURNER SPOTS (flank bruising)
-ACUTE ABD PAIN & N/V
Tx: Demoral (DONT give Morphine-spasms) |
DIVERTICULITUS | -PAIN IN LLQ (McBurneys point test)
(inflammation of the diverticulium) |
GLAUCOMA | -LOSS OF PERIPHERAL VISUAL FIELD (gun barrel vision)
-PAINFUL (Increased IOP0
Tx: Miotics, BB (timdol, diamox but not if allergic to sulfa drugs)
-DONT GIVE; Cogentin, Atropine, Visine |
ADDISON'S CRISIS | N/V, CONFUSION, ABD PAIN, EXTREME WEAKNESS, HYPOGLYCEMIA, DEHYDRATION, HYPOTENSION |
HYPERGLYCEMIA (HIGH BG) | THIRSTY, FREQ URINATION, DRY SKIN, HUNGER, BLURRED VISON, DROWSY, NAUSEA |
HYPOGLYCEMIA (LOW BG) | SHAKING, FAST HEARTBEAT, SWEATING, ANXIOUS, DIZZINESS, HUNGER, IMPAIRED VISON, FATIGUE, WEAKNESS, HA, IRRITABLE |
SICKLE CELL CRISIS | -SEVERE PAIN, INFECTION, ANEMIA
-TROUBLE BREATHING
Tx: IV fluids to help with cells getting stuck
DO NOT give DEMEROL |
HYPOPARATHYROID | CATS (same as low Ca)
-CONVULSIONS
-ARYTHMIA
-TETANCY
-SPASM & STRIDOR
Diet: Increase Ca and Decreased Pho |
HYPERPARATHYROID | will cause Ca to increase, PTU pulls Ca from bones into blood
-GROANS, MOANS, STONES, PHONE, BONE |
DI | decrease ADH (retains H20 in vascular space)
-POLYDIPSIA
-POLYPHAGIA
-POLYURIA
-weakness, FVD, Increases Na
Worry about SHOCK |
MYXEDEMA/HYPOTHYROIDISM | -SLOW PHYSICAL/MENTAL FX
-SENSITIVITY TO COLD
-DRY SKIN/HAIR
Tx: SYNTHROID (take in AM on empty stomach) |
GRAVES DZ/HYPERTHYROIDISM | -BULGING EYES
-ACCELERATED PHYSICAL AND MENTAL FX
-SENSETIVITY TO HEAT
-FINE/SOFT HAIR
Post Thyroidectomy; Semi fowlers, prevent neck flexion, trach at bedside |
TYROID STORM | -INCREASED T, P, BP
Tx: PTU/ Trapazole (prevents thyroid storm) |
CHOLINERGIC CRISIS | Caused by excessive medication --> STOP MED
Give TENSILION will make it WORSE (unlike MG) |
MG CRISIS | Sudden inability to speak or swallow --> LIFE THREATENING
TENSILON will make it better for a couple min, + rxn |
MG | -WORSENS with EXERCISE
-IMPROVES with REST
TENSILION test --> makes muscles tense, + rxn-imporves sx (unlike Cholenergic Crisis) |
CUSHINGS | Too much Aldosterone (retains Na and H20)
Can be caused by prednisone toxicity
-ALL UP (Na, BP, BG, BV)
-K goes DOWN
MOON FACE, PURPLE STRIATE, BUFFALO HUMP, INFECTION PRONE |
ADDISONS | Not enough Aldosterone (excretes Na and H20)
-All DOWN (Na, BP, BV, BG)
-K goes UP
BRONZING, RESTLESSNESS, WEAK, DECREASED WGT, ALLOPECIA |