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269 Cards in this Set
- Front
- Back
Breasts description
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Glandular lobes and ducts, fibrous tissue, fat
Tail, upper outer quadrant, lower outer quadrant, upper inner quadrant, lower inner quadrant |
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breast examination
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redness or other discoloration, thickness, and texture
If nipple inversion present for entire life – probably normal; if a new change in direction, probably cancerous First arm movement – arms above head Second arm movement – hands on hips Leaning forward three depths, three fingers, circular motion, three minutes per breast don’t forget to look from the sides Can have up to 6 extra nipples |
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Glands of Montgomery
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on areola – secrete lubrication to prevent fissures
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breast cancer signs
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Dimpling-cancer wrapped up around ligament and when patient moves, it pulls on ligament
cancer can cause hormonal changes within the breast (hair, aerola, skin) Peau D’ Orange-latent sign of cancer |
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seborrheic keratoses
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usually seen in women After 40
probably normal, sometimes not hyperpigmentation on areola |
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breast cancer rates
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1 in 8 women get breast cancer – comes from point prevalence in 80 year old women
Among 20 year olds – more like 1 in 1000s |
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intraductal carcinoma
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Light shining back from nipple – may be thick and hard
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Paget’s disease
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larger, irregular shaped areola
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Lymph flow in breast
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pectoral, sub-scapular, and lateral goes into central axillary – then to infraclavicular and then to supraclavicular
Lymph nodes – note size, shape, consistency, mobility, tenderness |
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gynecomastia
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Klinefelter’s and liver disease
obesity, steroids, marijuana use, hormone use |
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epitrochlear node
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in inner part of elbow
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darkening of skin under armpit (or velvety fluffy brown on neck)
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insulin resistance
if not diabetic, may be because of a GI malignancy |
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lichenification
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thickening under breast due to yeast infections
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Abdominal exam order
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position, exposure, inspection, auscultation, percuss, palpation {ask about tenderness prior to palpation
lightly (4 quadrants) deeply (4 quadrants) liver spleen (supine & right lateral position) kidneys tests for rebound tenderness ? Inguinal nodes femoral pulses} |
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Hodgkin’s lymphoma
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mass between shoulder and breast
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Referred pain
Upper right shoulder – Upper left shoulder – Red under left arm – Back – U shape – on left only – on right side – on both sides – Kidneys stones- Black circle – Long line down middle – |
Referred pain
Upper right shoulder – gall bladder Upper left shoulder – something under diaphragm Red under left arm – heart Back – pancreas U shape – on left only – diverticulitis, on right side – appendicitis (starts at navel); on both sides – kidneys and ureters Kidneys stones – patients do not sit still, pain in back Black circle – bladder Long line down middle – aortic |
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number 1 cause of bowel obstructions
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past surgeries, adhesions
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Striae
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-stretch marks from excessive weight gain with rapid loss
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Prominent bulge when patient raises head
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Diastasis recti
normal variation; (there is a solid fascia band there… just differences in fasica, rectus abdominus, and linea alba) |
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Caput Medusa
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enlarged twisting veinous plexus – advanced liver disease due to portal hypertension
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Esophageal varicies
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throwing up a lot of bright red blood
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Murphy’s sign
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tender when they take a deep breath, when palpating right side, they usually stop breathing in – gallbladder disease
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Costovertebral angle tenderness
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Tenderness on back punch – kidney problems, urethral problems
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Varicoceles
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bag of worms
If on left – not necessarily a vascular problem If on right – vena cava problems |
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Testicular cancer
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15 to 35 years old
Undescended testicles – higher rates of carcinoma |
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transillumination
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to see if it’s a hydrocele – light goes through fluid, not a mass
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phymosis
paraphymosis |
phymosis – inability to retract the foreskin – prevents adequate exam
paraphymosis – retract skin back, but then it gets stuck, end of penis will get swollen |
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Peyronie’s disease
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crooked, sometimes painful, erections
Palpable plaque or induration curvature of penis; Acquired benign condition |
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Condyloma
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wart – HPV
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Testicular torsion
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blood supply is cut off – emergency
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Balanitis
Clear discharge Milky discharge Candidasis |
Balanitis – inflammation of the glans
Clear discharge – Chlamydia Milky discharge – gonorrhea Candidasis – lots of red lesions; diabetes, high moisture conditions |
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Anal-Rectal examination
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Inspect, Palpate (Tone, Prostate, Masses, Stool), Guiac
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Pilondial Cyst
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incomplete closure of anus
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Prostatitis
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difficulty going to bathroom, fever – don’t want to do a lot of palpation in this case
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indications for rectal exam
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do on males over 40, any abdominal pain
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Benign prostatic hypertrophy rates
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– 50% >60 and 90% >80)
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parous
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term used to describe cervix after a women has a baby
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tenderness palpating ovaries during bimanual exam
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PID, pregnancy
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rectocele
cystocele |
rectocele (uterus prolapsing)
cystocele (bladder prolapsing into vagina) |
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nullparous
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cervix description when there have been no vaginal deliveries
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candida
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pruritis, pH 4-5, thick curdy discharge, hypahe present
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trichomonas
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discharge is thin and copious, pH 5-7, protozoa present, strawberry cervix
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Bacterial Vaginosa
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odor, pH 4-6, scant discharge, clue cells present
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chromosomal abnormality
subdural hematoma |
Microcephaly –
Macrocephaly – |
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measuring pediatric heights and head circumference
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Head circumference – measure at every exam for first 2 years, plot on chart
Height – supine length measure up to 2-3 years old; erect height for 2-18 year olds, plot on chart |
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pediatric respitory rates
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Newborns 30-80
Early childhood 20-40 Late childhood 15-25 |
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temperature in pediatrics
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Rectal most accurate
Fever >100 in infants – sepsis |
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fontanelles
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Anterior fontanelle closes at 4-26 months
Posterior fontanelle closes by 2 months Bulging – increased intracranial pressure Depressed – dehydration |
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Plagiocephaly
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asymmetric craniostenosis due to premature closure of lamboid or coronal sutures
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Pectus carinatum
pectus excavatum |
Pectus carinatum (pigeon chest); pectus excavatum (funnel chest)
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eye sight in pediatrics
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Birth – blinks
1 month – fixes on objects 3 months – eyes converge 12 months – 20/50 |
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ears and hearing in pediatrics
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To look in ear, pull pinna downward
Draw line from where eye makes a point to the ear – should see about 1/3 of ear above the line Hearing – birth-4months – startle reflex, 4 – widen eyes to sound, 6 – turns head to sound |
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Innocent murmurs
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loudest at LSB, 2nd and 3rd interspaces
40% of kids have a heart murmur Location: Loudest LSB, 2nd, 3rd ICS Radiation: Localized Timing: Midsystolic usually Duration: Usually short Intensity: Grade 2/6 usually Quality: Soft Other: Rest of CV/Resp exam normal |
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Still’s murmur
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most common, 2-adolescence, dimishes with sitting, standing, valsalva
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Venous hum
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common after 3, turbulence in subclavian and jugular veins, disappears if supine
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Congenital Hip Dysplasia
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Increased risk in first-born females, breech birth, or family history of DDH
Ortolani test – abduct external rotation – palpable click – test for posteriorly dislocated hip |
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Barlow test
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adduct, internal rotation – femur slips – dislocate an intact but unstable hip
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Primitive Reflexes
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Placing/stepping – birth – 1-2 months
Moro – birth – 3 month (cradle the baby’s head, bring them down, hyperextend the neck (as if they were falling) – they will flail their arms – should be symmetrical on both sides Grasp – birth – 3 months Tonic neck reflex – 1-4 months - turn their head to one side – they will extend the arm on that side and bring the other one up (like a fencer) |
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signs of a child who has severe allergies
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– allergic shiners (blue under eyes), Dennie’s lines (creases under lower eyelids), nasal pleat (allergic salute)
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most common in Kesselbach’s plexus
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Nosebleeds
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Grading tonsilis
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4+ – kissing tonsils
3+ – close to edge of uvula 2+ -regressed 1+ -barely peaking out |
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Scoliosis
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lateral curvature of spine, onset after 9-10, 80% idiopathic, 20-40 degrees – brace
40+ degrees - surgery |
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Tinea versicolor
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light hypopigmented macules (topical fungal infections)
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Tinea corporis
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ringworm
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Dupuytren’s contracture
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- pinky or ring finger contracted up – mainly in males of northern European descent – underneath there is a spider web-like mesh of tissue covering the nerve
loss of extension, flexion, and abduction |
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Rheumatoid arthritis
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atrophy of interosseous muscles on hand, alignment not normal
outer three fingers pointed out – ulnar deviated; swelling, deformities; scaly skin; vertical lines down middle of nails |
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Beau’s lines
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nail stops growing when you get really sick, when you recover it starts growing again – horizontal lines
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Raynaud’s
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very pale painful skin – cold and stress causes the circulation to shut down, different colors on palms of hand
very painful in cold weather, digits can auto amputate |
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Anatomic snuffbox
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extensor pollicis longus tendon above and extensor pollicis brevis tendon below
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Scaphoid fracture (navicular bone)
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tender on palpation of anatomical snuffbox
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Scapular winging
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Can have them do a push up against the wall. , a child with no trauma-is viral, presence of laxity is a torn tendon, SALT
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motions of the shoulder
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Flexion – arms straight up
Extension – arms back Abduction – away from body, over head Adduction – cross in front of body Internal rotation – elbows bent – arms up External rotation – elbows bent, arms down |
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measure leg length
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Medial malleus to anterior superior iliac spine
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Trochanteric bursitis
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side of hip hurts
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Knee muscles
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Above - Vastus medialis and vastus lateralis
Sides - medial patellar retinaculum and lateral patellar retinaculum |
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Baker’s cyst
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Feel in popliteal fossa (behind knee) for swelling
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Genu recorbotum
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knee curves backward – more than 0 degrees
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Ligamentous laxity
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can stretch knee farther than “normal”
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Marfan’s syndrome
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very tall, ligamentous laxity, narrow teeth, elastic aorta
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Injury to posterior cruciate ligament
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could cause knee to sag backwards
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Posterior tibial tendon dysfunction
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one heel would go in, one would not
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Hallux valgus
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bunions
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spinal curvatures
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Cervical lordosis
Thoracic kyphosis Lumbar lordosis |
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pullman’s test
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dorsiflex foot, causes pain – if clot is in calf, not if in thigh
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eye movement Nerves
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II. Optic – visual acuity, visual fields, papillary response to light (afferent pathway)
III. Occulomotor – superior rectus (moves eye up), inferior rectus (moves eye down), medial rectus (moves eye medial), inferior oblique (moves eye up) IV. Trochlear – superior oblique (moves eye down) VI. Abducens – lateral rectus (moves eye laterally) VII. Facial – raise eyebrows, frown, close eyes, close mouth, pucker, taste on anterior 2/3 tongue III, IV, V – Extraocular muscle control, papillary reaction, eye position Abnormal or Asymmetric Pupils – II and III – optic and occulomotor work together to control papillary constriction and dilation |
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cranial nerve names and functions
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I. Olfactory – not brainstem, smell, test each nostril separately
II. Optic – visual acuity, visual fields, papillary response to light (afferent pathway) III. Occulomotor – superior rectus (moves eye up), inferior rectus (moves eye down), medial rectus (moves eye medial), inferior oblique (moves eye up) IV. Trochlear – superior oblique (moves eye down) V. Trigeminal – motor: muscles of mastication – palpate temporal and masseter muscles sensory: V1 opthalmic, V2 maxillary, V3 mandibular VI. Abducens – lateral rectus (moves eye laterally) VII. Facial – raise eyebrows, frown, close eyes, close mouth, pucker, taste on anterior 2/3 tongue, bells palsy; asymmetry of lower face only VIII. Acoustic – auditory acuity, weber and rinne, balance vestibular division IX. Glossopharyngeal – motor: pharynx sensory: ear canal, taste posterior 1/3 tongue X. Vagus – palate elevation (say “ah”), dysphagia, slurred speech, hoarse, gag reflex on comatose patients XI. Spinal accessory – sternomastoid and trapezius (shrug) XII. Hypoglossal – tongue deviation during protrusion (points to affected side) |
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pediatric sight milestones
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In children
Age 3 20/50 Age 4 20/40 Age 5 20/30 Age 6 20/20 |
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Vagus
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– increased parasympathetic stimulation to the heart
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Horner’s syndrome
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sympathetic pathway, ptosis, miosis – small pupil reacts to light, anhidrosis
(40% idiopathic, 13% tumor, 12% cluster headaches, 10% iatrogenic) |
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Levels of Consciousness
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• Alert – normal response to verbal questions
• Lethargic – drowsy, responds to raised voice • Obtunded – appears asleep, responds slowly after shaking • Stuporous – appears asleep, responds to painful stimuli only • Comatose – unarousable, does not respond |
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Romberg Test
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stand with eyes open, then closed
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Pronator Drift
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arms up, eyes closed, tap fingertips gently
Positive sign is most likely a sign of stoke |
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Tandem gait
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heel-to-toe – requires good sense of balance
Circumducted gait-result of a stroke Shuffle-Parkinson’s Disease |
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Muscle Strength graded
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0/5 no muscle movement
1/5 visible muscle movement, no movement at joint 2/5 movement at joint, but not against gravity 3/5 movement against gravity, but not against resistance 4/5 movement against resistance, but less than normal 5/5 normal strength |
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Reflexes grading
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0 absent
1+ hypoactive 2+ normal 3+ hyperactive 4+ hyperactive with clonus |
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Plantar response (Babinski sign)
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to assess upper motor neuron lesions
Incorrect to say that a patient has a “normal” or “down-going Babinski”… if normal simply state the plantar reflex is normal or that the toes are down going |
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Point-to-point movements (coordination)
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their finger to your finger and then to their nose
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Position sense
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proprioception on big toe – bilaterally with eyes closed
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Graphesthesia
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draw number on hand
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Stereognosis
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object recognition
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CN I
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olfactory
test smell in each nostril |
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CN II
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optic
test visual fields, acuity, pupil responses to light |
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CN III
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occulomotor
pupillary size and reaction to light, direct and consensual (with help from CN II) Occulomotor-moving eyes |
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CN IV
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Trochlear
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CN V
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trigeminal
test jaw clenching and temporalis and masseter strength, also test V1, V2, and V3 |
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CN VI
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Abducens
lateral rectus (moves eye laterally) |
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CN VII
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Facial
test by having patient close eyes, smile, and pucker lips |
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CN VIII
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acoustic
test with Weber and Rinne |
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CN IX
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glossopharyngeal
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CN X
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vagus
parasympathetic response, abrupt flow to slow down heart rate, typically will yawn right before you pass out |
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CN XI
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spinal accessory
test strength of trapezius and sternomastoid muscles |
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CN XII
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hypoglossal
test by having patient protrude tongue and move side to side |
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C5 and C6 test
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bicep and brachioradialis reflexes nerve numbers
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C6 and C7 test
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tricep reflexes
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L2-L4 test
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patellar reflexes nerve numbers
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S1 test
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achilles reflexes
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Clonus test
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push it up and foot flaps-normal 1 or 2 flaps, positive could be a sign of MS
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Posterior column is associated with what senses
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Proprioception
Moving toe up/down Vibration Fine touch (paper clip |
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spinothoracic is associated with what senses
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Pain
Temp Crude Touch |
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Monofilament test
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for diabetic test, should feel when the filament breaks
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Fluid extravasation
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infusing fluid into arm and not vein with IV’s
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Ulnar problems
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have weakness in the hand
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Radiculapathy
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when the sciatic pain goes to foot
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Vastus medialis obliquous (VMO)
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on stairs and is in front of knee due to weak VMO, brace, rest, and must strengthen VMO by doing straight leg raises w/ external rotation
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Positive Trendelenberg sign
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gluteus maximus weakness, lift leg and is hip drops
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hip pain
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Almost all hip pain will be anterior and radiate into the knee, opterator nerve,
Internal rotation is tender is bad pediatrics will complain about knee pain although the problem is hip |
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Sciatica
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inflammation of the sciatic nerve, common with guys and thick wallets who sit on it
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Ecchymosis around toes
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can be a sign of an ankle injury in which they have not elevated the foot and gravity has pooled the blood
Loss of boney landmarks is due to significant amount of fluid |
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Anterior talo fibular
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main tendon involved in most ankle sprains with rolling of ankle sprains
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Eccymosis and tenderness around maleolus
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could be torn deltoid ligament or fracture, need xray
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ankle sprain grades
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Grade 2-limping
Grade 3-eccymosis lateral and medial |
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Pes planus
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flat footed, no arch
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Plantar warts
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under metatarsal heads-calcuses has formed, can be from wearing high heels-get xray
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morton’s nuroma
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tenderness between 3 and 4th interspace of metatarsal head
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developmental milestone at 8 months
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pincher grasp, pick up things, fine motor skills
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Autism
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is a common diagnosis in children today
parents complain child never smiles, doesn’t hear, no responses Is very key to catch early and repair or make adjustments |
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lactating when not pregnant
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-Psychotropic drugs
-adenoid tumor -over-stimulation from sexual activity |
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Linea Nigra
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line down mid line of abdomen (normal
|
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Prostate Carcinoma rates
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(29% of male CA)
|
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considerations before a pelvic
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LMP
• Pregnancy • Bladder Fullness • Prior Surgery • Prior Exam Results • Psychological Trauma • Environment |
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when to palpate Bartholin’s
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if infection is suspected
|
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patient unable to make fist
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possible CVA or arthritis
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upper and lower face Asymmetry
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Bell's Palsy
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Asymmetry
Lower face |
Central lesion -
Brain- involving only part of the face |
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Hoarse Voice-nerve affected
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X-vagus
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Articulation
Problems-nerves affected |
(V, VII, X, XII)
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tongue deviations
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point to affected side
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uvula deviations
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point to unaffected side
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Bilateral small pinpoint pupils
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• Hypothalamic injury
• Metabolic encephalopathy • Hemorrhage in the pons • Morphine Heroin Narcotics • Chemical exposure-nerve agent |
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screening test used for developmental milestones for pedis
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Denver Developmental Screening Test
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retinopathy
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If visual acuity is off, do pinhole test, which takes out refractive error. If pinhole test is also positive, patient could have...
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head injury
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projectile vomiting, blown pupil-suspect acute bleed
Anyone with head trauma needs a cranial nerve evaluation Trauma involving tip of the nose, must worry about blindness |
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Brain Tumor
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papilloedema, visual deficits, reflex changes (babinski’s sign-adult should have toes go down, but if the toes go out in a dorsal flexion-upper motor neuron lesion)
Headaches-later sign of brain tumor and will usually have other symptoms before the headaches (rarely will have normal neuron exam, but look for a change in HA symptoms/severity) |
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Patient with large reactive pupils
hole in septum |
cocaine use
|
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diabetic
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Monofilament test for diabetic test, should feel when the filament breaks
Pupils symmetrical, eye points down and out |
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testicular exam
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Palpate testicles, then follow cords up and have patient cough
Look posteriorly and move testicles to each side to see palpate inguinal area for lymph nodes |
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most common hernia in males
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indirect inguinal hernia
|
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Vitiliga
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loss of pigmentation
(michael jackson) |
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Anal Rectal exam
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Inspection:
Tone for history of incontinence Back pain in elderly is assoc with rectal cancer and must do rectal exam Palpate for masses Guiac the stool in the vault |
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Perirectal Abscess
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emergency, any erythema that extends down to rectum, cant always differentiate between cellulitis and this abscess, bowel fluid is leaking out and can go septic really rapidly, do not let patient leave, immediately have patient go to ER and be evaluated by surgeon
|
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Rectal Prolapse
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really bright pink, fleshy, bubble looking, mucosal tissue on outside of anus, rectal tissue coming through anus
|
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Rectal Neoplasm
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flesh colored, large mass, irregular borders, pigmented, punduncles-often though by the patient that they have hemorrhoids
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Digit exam
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Preferred position – lying on side, bottom leg straight, top bent (lateral decubitus position)
Touch anus, don’t stick finger in…. looking for the “anal wink”, have patient bear down which allows sphincter to relax in order for you to put your finger in, assure them that they will not have a BM Lubricate Gently insert finger but do not fight sphincter because you can tear something including your glove Do this for anyone with a possible spinal cord injury or transient paralysis Feel all the way around Then feel the prostate – with flexed DIP joint; should feel firm; should feel a sulcus (canal) in the middle of the prostate If it feels swollen or like a water balloon, could be enlarged, feel for nodules Do hemocult test – if it turns blue, positive – hemolyzed blood in stool |
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Paniculus
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extra adipose tissue that is like an apron and can be difficult to do pelvic exam
|
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Adnexa
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from the sides of the uterus - ovaries and fallopian tubes
|
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pelvic exam
|
Tell the patient you are going to examine….you may feel pressure and a little discomfort
Look for hair distribution and spread for lice Palpate lymphnodes Spread the labia Stay away from the clitoris Do not milk urethra unless indicated Palpate for the bartholins gland, checking for infection and swelling C position of hand over speculum – very good Go in at angle, then turn Push down on PC muscle as you insert If someone is very large, may have a lot of folds to make examination difficult, use a condom to hold side walls back Lack of rugeations is lack of estrogen and thin lining, common in elderly Cervix should be shiny, moist Swab test to see what color discharge is Clear or yellow Pap smear: Spatula – run it around on the surface Brush – insert into os slightly bi-manual exam: – feel about what size the fundus is if you can -if it hurts to move the cervix around – possibility of ascending PID, pregnancy Cervical motion tenderness with pain on palpation If patient comes off the table with palpation-chandalier sign-PID -will feel soft like a hard boiled egg, very small, will not always feel in larger abdomen, if you feel in a larger person, its swollen Spread the anus for visual inspection: rectal vaginal exam – to look at strength of vaginal wall |
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delayed or precocious puberty, hypogonadism
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virilism
|
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truncal fat with thin limbs
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Cushing's Syndrome
|
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fever or pyrexia
|
extreme elevation in temp above 106F
|
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hypothermia
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abnormally low temp below 95F
|
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carotenemia
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high levels of carotene yellow color in palms, soles, and face
|
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causes for central cyanosis
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adv lung disease, cong heart disease, abn Hbg
|
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Herpes Zoster
|
vesicles in a unilateral dermatomal pattern
|
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sparse/coarse hair texture vs. silky fine hair texture
|
hypothyroidism vs. hyperthyroidism
|
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macule
|
flat, small <1 cm,
i.e. freckle, petechia |
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papule
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skin elevated solid mass < .5 cm
|
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patch
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flat and is larger than a macule >1 cm
|
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nodule
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skin elevation > 1 cm
a very large nodule is a tumor |
|
wheal
|
irregular borders, usually red, and usually hives
|
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vesicle
|
up to .5 cm raised, fluid filled, blister looking
i.e. herpes |
|
bulla
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> .5 cm fluid filled raised, bubble looking, usually result of a burn
|
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pustule
|
elevated filled with pus
i.e. acne, impetigo |
|
primary lesions
|
macule, papule, pustule, patch, plaque, tumor, wheal, vesicle, bulla
|
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secondary lesions
(result of changes to 1 lesion) |
erosion, ulcer, fissure, scale, crust
|
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erosion
|
loss of superficial epidermis, moist, no bleeding
i.e. after popping blister |
|
ulcer
|
deeper loss of skin surface, may bleed and scar
i.e. syphillis chancre |
|
fissure
|
linear crack in skin
i.e. athletes foot |
|
crust
|
dried residue usually serum, pus, blood
i.e. honey colored in impetigo |
|
scale
|
thin flaky exfoliated skin surface
i.e. dandruff, psoriasis |
|
plaque
|
elevated > .5 cm
(macule is to patch as papule is to plaque) |
|
cafe-au-lait spots
|
uniformly slightly pigmented spots with irregular borders (macules and patches), fairly benign unless there are 6 or more >1.5 cm (neurofibromatosis)
|
|
spider angioma
|
red spider like spot (looks like broken vessels) can be liver disease, pregnancy, vit B def and also can be normal
|
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spider vein
|
bluish vein most often on legs, can be varicose veins
|
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cherry angioma
|
little ruby red spots usually on trunk, usually with aging
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petechia/purpura
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deep red to purple means blood outside the vessels and can be a blood disorder
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kaposi's sarcoma
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malignant tumor usually with AIDS and can be anywhere in several forms, pigmented, usually purple on palate in mouth
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hirsutism
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excessive facial hair in women
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myopia
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impaired far vision
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presbyopia
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impaired near vision usually found in older people
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Legal blindness
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20/200
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visual field defects on R side of both eyes
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homonymous hemianopsia
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visual field defects on r side of one eye and the L side of the other
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bitemporal hemianopsia
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enlarged blind spots
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glaucoma, optic neuritis, papilledema
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abnormal protrusion of the eyes
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Grave's Disease
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cresent shadow on iris with shining of light
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increased risk for glaucoma
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miosis
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constriction of pupils
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mydriasis
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dilation of pupils
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nystagmus
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seen in many neurological conditions
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absence of the red reflex
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cataract, detached retina, artifical eye, retinoblastoma
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enlarged physiological cup
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glaucoma
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an important cause of central vision loss
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macular degeneration
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exostoses
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nontender nodule swellings covered by normal skin in ear canals, can obscure drum but is benign
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red bulging ear drum
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acute otitis media
may decrease motility |
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amber looking ear drum
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serous effusion
may decrease motility usually caused by upper respitory viral infection |
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unusually prominent short process and prominent handle that looks more horizontal
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retracted ear drum
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in unilateral conductive hearing loss (weber test)
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sound is lateralized to the impaired ear because sound is heard through the bone longer than air
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in unlateral sensorineural hearing loss (rinne test)
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sound is heard in the good ear because sound is heard longer through air
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torus palatinus
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midline lump on palate, normal in some
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tracheal deviation
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mediastinal mass, atelectasis, pneumothorax
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marcus gunn pupil
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pupil responds less vigorously and then dilates while the other responds to light normally/optic nerve damage
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xanthelasma
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raised yellowish plaques in the skin near eyes along nasal portions usually due to high cholesterol
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angioedema
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bottom lip swollen, very red, nonpitting, develops rapidly, usually as a result of an allergy
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clubbing of the nails
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long sustained hypoxia or lung cancer
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APGAR scoring
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assesses the infant's immediate adaptation to extrauterine life by making 5 observations and assigning a score of 0, 1, or 2, the total score can be 0-10
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at 1 minute APGAR, a score 7 or less indicates...
4 or less.... |
nervous system depression
severe depression needing resuscitation |
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nerves that attach to spinal cord
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31 pairs
8 cervical, 12 thoracic, 5 lumbar, 5 saccral, 1 coccygeal |
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What is the name for a folded false synovial membrane in the knee
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Medial plica
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proper sequence for lung examination
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Inspect, palpate, percuss, ascultate
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What muscles help to control the mitral valve
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Papillary
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What is the most vascular structure in the femoral triangle
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Femoral artery
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What will accentuate a mitral valve prolapse, other than the left lateral decubitus position
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Val Salva
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What murmur occurs between S1 & S2 with no gap
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Pansystolic/holosystolic
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What condition will give papillary involvement in CN III abnormality
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Pressure from aneurysm or tumor
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What causes S1 sound
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Closure of mitral and tricuspid valves (AV valve closure)
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What artery divides into the pedis and tibial
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Popliteal
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What causes displacement of PMI
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Pregnancy, cardiomegaly, CHF
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red streaks up an extremity is a sign of infection and is called
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Lymphangitis
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What is the normal range from an oral temp in Celsius
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35.8 to 37.3
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Mobile, non-tender mass in a woman age 15 – 20
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Fibroadenoma
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Intense urge to have a bowel movement
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Tenesmus
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Blue feet and nail beds 30 min. after birth
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Acrocyanosis
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Condition associated with acanthosis nigricans-velvety skin in axilla
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occult cancer
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Most common cause of rapid recent weight loss in child
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fluid loss / fluid shifts
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Ethnic group with lowest risk of breast cancer
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Asian
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BMI range for overweight
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25 – 29.9
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Grey or lightly colored stool
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acholic (without bile)
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components of APGAR score
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Heart rate greater than 100; Respiration; muscle tone; color (pink)
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Most common cause of nonpuerperal galactorrhea
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Hormonal changes and drugs
pituitary tumor |
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Large yellow or grey greasy stool
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Steatorrhea.
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Thin pencil-like stool
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apple core tumor of sigmoid colon
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Blood pressure =
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CO x TPR
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Name of area posterior and lateral to cervix
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Fornix
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Name of the test for carpal tunnel: (hands inward)
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Phalen’s
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Term for defined, jerky, uncoordinated and uncontrolled movements
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ataxia
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Severe cervical motion tenderness suggests what
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PID, Salpingitis, tubal or ovarian cyst.
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Term for episodic muscular ischemia produced by exercise
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Claudication
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Name for physical test for arterial circulation in hand
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Allen test
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Cause of paradoxical splitting of S2 during EXPIRATION
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Bundle Branch block
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Name 2 hip bursas
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Trochanteric, Psoas, Ischial
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What is color of skin in primary chronic venous insufficiency
|
Brown
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One cause of a heart murmur not related to valvular abnormalities
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Pregnancy, Anemia, fever, hyperthyroidism
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Term for patient making up false facts to cover up a mental status deficit
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Confabulation
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The spinal pathway responsible for position sense and vibration
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Posterior Column
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What is it called when the femoral pulse is later and fainter than radial pulse
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Coarctation
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What is the anatomical structure between the medial femoral condyle and the tibial plateau
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Medial meniscus
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RLQ pain associated with LLQ palpation
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Roving’s sign
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What is last type of memory to go in dementia
|
Long term or remote memory
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When would you not use mydriatic drops
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Head injury, coma, narrow angle glaucoma.
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What is the proper name for the Mini-mental status exam
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Folstein
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