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49 Cards in this Set
- Front
- Back
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Janeway lesions |
Painless red macules on palms or soles |
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Splinter hemorrhages |
Painless lesions on nails |
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Osler nodes |
Painful red nodes on pads of fingers/toes |
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Pulsus paradoxus |
Inflate to 20 above systolic Deflate till K1 on exp Continue till continuous K1 Difference >12 is pulsus paradoxus (Tamponade) |
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Pulsus parvus et tardus |
Aortic stenosis Slow rise and fall |
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Pulsus alternans |
Alternating weak and strong LV dysfunction |
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De Mussets sign |
Bobbing head with systole = AR May see cyanosis |
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Normal JVP |
<=3 ASA A wave dominant |
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Kussmauls |
Increase in JVP with inspiration Constrictive pericarditis (NOT Tamponade) RHF |
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+HPJ reflex |
- JVP fails to correct within 10 sec - JVP drops more than 4 cm - do if no elevated JVP but suspect LHF
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Apical impulse |
5th ICS MCL - sustained if >1/2 systole - dilated if >4 cm |
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Regurg murmur maneuvers |
Isometric hand grip |
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S3 & S4 |
Hear using bell S3- eccentric hypertrophic (reg) S4- concentric (stenosis) |
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Murmur: Aortic stenosis |
Systolic crescendo-decrescendo Radiates to carotids and apex |
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Murmur: AR |
Loudest at LLSB Diastolic decrescendo Radiates along left sterna border Louder with leaning forward, exhalation |
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Murmur: TR |
Pansystolic LLSB |
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Cap refill |
Press for 5 sec Abn >5 sec |
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RA deformities |
Z deformity thumb Swan neck- ext PIP, flex DIP Boutonnière- flex PIP, ext DIP Ulnar or radial deviation of wrist |
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Burgers test |
Life leg to 90 x 2 min Abn pallor when raised, red flush spreading up from toes when dangled |
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Percuss liver |
3rd ICS MCL |
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OA: hand deformities |
Bouchard nodes- PIP Heberdan- DIP |
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RA deformities |
Z deformity thumb Swan neck- ext PIP, flex DIP Boutonnière- flex PIP, ext DIP Ulnar or radial deviation of wrist |
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Spine landmarking |
C7 base of neck T3 spinous process scapula T7 base of scapula L3/4 top of iliac crests S2 between PSIS |
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Modified schrobers test |
Landmark PSIS 10 cm above 5 cm below Bend over Increase < 5 cm = ankspond |
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Thoracic spine: ROM |
Measure at xiphoid Deep inhalation Expansion <4 cm = Ankspond |
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Occiput to wall |
Abnormal >4 cm = ankspond |
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Lower motor neuron findings |
Decreased muscle bulk, muscle atrophy, fasciculations |
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Spasticity |
Increased tone with fast movements |
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Lead pipe rigidity |
Increased tone with slow movements |
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Cogwheeling |
Increased tone with slow movements, and alternating resistance and relaxation |
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UE reflexes and nerve |
Biceps, brachioradialis- C6/LMN Triceps- C7/LMN Brachioradialis & triceps- radial |
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UE sensation |
Back (Definition) |
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Cortical sensation |
- stereo genesis (obj recog) - two point disc (min 6 mm) - graphesthesia (# Palm, 0, 8, 3) - tactile stimulus (In IV’s bilateral) |
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LE reflexes and nerve |
Patellar- L3,4 Achilles- S1 |
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LE sensation |
Back (Definition) |
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Gait |
Symmetry, stance, fluidity |
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Parkinson’s gait |
Flexed posture Shuffling steps Difficulties initiating gait En bloc turning Stop in doorways Diminished arm swing Festination Retro pulse on |
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Parkinson’s: CN exam |
Anosmia Lack of facial expression and blinking Hyper salivation Jaw & tongue tremor Glabellar tap |
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Parkinson’s- bradykinesia |
- finger tapping - punching and circling - heel tapping |
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Neuro exam- sensation |
Temperature Vibration- reduced with dorsal column lesion Proprioceptiom- as above |
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Stroke- vision changes |
Homonymous hemianopia contractural your MCA or PCA stroke
Parietal love, visual extinction |
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Bells palsy |
Complete hemi facial droop Incomplete eye closure Hyperacusis |
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Argyle Robertson pupil |
Don’t respond to light but accommodate |
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Eye deviation |
Back (Definition) |
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CXR: quality |
Penetration- see vertebrae Inspiration- 6 anterior ribs Rotation |
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Bad news |
Setting Perception Invitation Knowledge Emotions Strategy and summary |
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Capacity assessment |
Understanding- med condition, risks and benefits of tax, alternative options Rationale Retention Repetition |
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Childhood vaccines |
Understanding Concerns Other people present? Variety of information… |
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Types of shock |
- distributive- septic, anaphylactic - cardiogenic- cardiac arrhythmia, cad - obstructive- PE, Tamponade, tension pneumo - hypovolemic |
