Medical Terminology and Diagnosis Review, Exams of Nursing

Download Medical Terminology and Diagnosis Review and more Exams Nursing in PDF only on Docsity! Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. Normal *oral temperature* - Answer 98.6 F Normal *rectal and tympanic temperature* - Answer 99.6 F Normal *axillary temperature* - Answer 97.6 F Normal *temperature range* - Answer 96.0-99.5 F or 35.0- 37.5 C Normal *adult pulse* - Answer 60-100 bpm Normal *newborn pulse* - Answer 120-160 Normal *elderly pulse* - Answer 70-80 bpm Normal *adult respiratory rate* - Answer 14-18 cycles per minute Normal *newborn respiratory rate* - Answer 44 cycles per minute Normal *adult blood pressure* - Answer 90-120/60-80 Hypertension values - Answer over 140/90 Hypotension values - Answer under 90/60 Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. *Adie's pupil* - Answer *Sluggish pupillary reaction to light* that is *unilateral* and caused by a *parasympathetic lesion of CN III* *Anisocoria* - Answer *Unequal pupil size* *Argyll Robertson* - Answer *Bilaterally small and irregular pupils that accommodate but do not react to light* Seen with *syphilis*. AKA prostitute's pupil *Arroyo sign* - Answer *Sluggish pupillary reaction do due hypo-adrenalism*. Associated with *Addison's disease* *Blepharitis* - Answer *Inflammation of the eyelid* seen with *seborrhea, staph infection, or inflammatory processes* *Cataracts* - Answer *Opacities seen in the lens* and also has an *absent red light reflex* commonly seen in with *diabetes* and in the elderly, Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. what is it bilateral = ____ unilateral = _____ - Answer *Lid lag/ failure to cover the eyeball*, can be seen bilaterally with *Graves' disease* unilaterally with *tumor* *Glaucoma* what is it what will patient notice what sign is present - Answer *Increased intraocular pressure causing cupping of the optic disc* The *patient will notice blurring of their vision especially in the peripheral fields* as well as *rings around lights* *Crescent sign* will be present upon tangential lighting of the cornea Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. *Normal cup to disc ratio* - Answer Greater than 1:2 *Hordoleum* - Answer AKA sty *An infection of the sebaceous glands causing a pimple or boil on the eyelid* *Horner's syndrome* - Answer *Ptosis, miosis, and anhydrosis* is on the same side as an interruption to the cervical sympathetics *Hypertensive retinopathy* what is it what signs - Answer *Damage to the retinal vessels/ background* will show these signs: copper wire deformity silver wire deformity A-V nicking flame hemorrhage cotton wool soft exudates Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. *Internal ophthalmoplegia* - Answer *Dilated pupil with ptosis and lateral deviation* *does not react to light or accommodation* associated with *multiple sclerosis* *Iritis/ uveitis* - Answer *Inflammation of the iris* associated with *ankylosing spondylitis* *Macular degeneration* - Answer *Most common reason for blindness in the elderly* *central vision lost* *macular drusen* is an early sign (yellow deposits under the retina) *Miosis* - Answer *Fixed and constricted pupils* that react to light and accommodate. Associated with *severe brain damage, pilocarpine medications, and narcotic use* Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. *Direct Light Reflex* - Answer II and III *Consensual Light Reflex* - Answer III *Accomadation* - Answer II and III *Visual Acuity* - Answer snellen *Fields of Gaze* - Answer III, IV, VI *Acoustic neuroma* - Answer *Benign tumor of CNVIII, schwannoma* characterized by *hearing loss, tinnitus, vertigo, and presence of tumor on CT or MRI* *Acute mastoiditis* - Answer *Bacterial infection of the mastoid process* presents clinically with the same signs and symptoms as acute otitis medial with the addition of *inflammation and palpatory tenderness over the mastoid*, hearing loss is commonly associated with it Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. *Acute otitis externa* - Answer *Infection of the outer ear*, commonly associated with *swimming* (AKA swimmer's ear), *patient experiences inflammation and pain of the outer ear*, tugging on the *pinna will be painful* *Benign paroxysmal positional vertigo* - Answer *Brief episode of vertigo brought on by a change of head position. Diagnosed by having the patient* perform the Dix-Hallpike Maneuver and treated with Epley's Maneuver *Eustachian tube block* - Answer Retraction of the tympanic membrane *Meniere's disease* - Answer Disorder characterized by *recurrent prostrating vertigo, sensory hearing loss, tinnitus, and feeling of fullness in the ear* *Presbycussis* - Answer *Sensorineural hearing loss that occurs in people as they age*, may be affected by genetic or aquired factors *Purulent Otitis Media* - Answer AKA bacterial otitis media; *bacterial or viral infection in the middle ear* Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. *the tympanic membrane presents with a red appearance dilated blood vessels, and bulging* *Serous Otitis Media* - Answer *Effusion in the middle ear* resulting from *incomplete resolution of acute otitis media or obstruction of the Eustachian tube*. The condition is usually chronic and the fluid is *amber with bubbles* *Tinnitus* - Answer Ringing in the ears *Vertigo* - Answer Abnormal sensation of rotary movement associated with difficulty in balance, gait, and navigation of the environment Normal Hearing: *Weber Test* *Rinne Test* - Answer Normal Hearing: *Weber Test* equal bilaterally *Rinne Test* AC > BC (+) Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. *deep furrows on the surface of the tongue* scraped off easily considered a normal variant *Leukoplakia* - Answer *Pre-cancerous lesion of white patches that are adherent to the surface of the tongue* and not easily scraped off *Acromegaly* - Answer *Excessive production of growth hormone* beginning in middle age; results in *abnormal growth in the hands, feet, and facial bones* *Gigantism* - Answer *Excessive production of growth hormone prior to skeletal maturity* Hyperthyroidism vs Hypothyroidism - Answer Hyper mc = autoimmune Graves Hypo mc is Hashimotos hypo congenital = cretinism (decreased mental and physical capacity) *Common migraine* Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. Age/sex Site Characteristics Provocation Lab - Answer 1) *Sex*: Female, most commonly in the reproductive years 2) *Site* unilateral or bilateral, 3) *photophobia, throbbing, nausea, sound sensitivity* 4) *provoked* by bright light, red wine, and menstration, and stress, *Classic migraine* Age/sex Site Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. Characteristics Provocation Lab - Answer 1) *Sex*: Female, most commonly in the reproductive years 2) *Site* unilateral 3) *AURA* and *photophobia, throbbing, nausea, sound sensitivity* 4) *provoked* by bright light, red wine, and menstration, and stress, *Hypertension headache* Age/sex Site Characteristics Provocation Lab - Answer 1) *Sex* Adult usually overweight male Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. 2) *site* band around head 3) *characterized* by band-like pressure and muscle tightness, 4) *worsened by* fatigue, tension, stress, and work *Temporal arteritis* Age/sex Site Characteristics Provocation Lab - Answer 1) Patient is over 50 years old 2) complains of a headache that is unilateral and temporal 3)persistent burning, aching, throbbing headache over one eye, 4) scalp is sensitive and arteries are tender Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. labs will show elevated ESR and CRP, special test to do is biopsy and will see giant cells *Polymyalgia Rheumatica* is _____ - Answer Headache with neck and shoulder stiffness and pain *Cervicogenic headache* Age/sex Site Characteristics Provocation Lab - Answer AKA vertebrogenic seen in adults, pain in occipital or upper cervical region Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. decreased ROM in upper cervical and occiput head movement makes headache worse, do flexion/extension X-rays first, then adjust *Sinus headache* Age/sex Site Characteristics Provocation Lab - Answer 2) Localized headache that changes with body position 3) a steady throb, with local tenderness over the maxillary or frontal sinuses 4) provoked by chronic sinusitis Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. $$$$$ Increased intracranial pressure -> papillodema *Brain tumor headache* Age/sex Site Characteristics Provocation Lab - Answer 1) any age 2) any place with pain changing with body position 3) Symptoms have been occurring for a while and are progressively worsening, throbbing headache that doesn't respond to pain medication, patient has no history of high blood pressure or head trauma refer for MRI and CT of brain and to a neurologist. Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. $$$$$ Increased intracranial pressure-> papillodema Meningeal irritation headache Age/sex Site Characteristics Provocation Lab - Answer 1) any age 2) Neck pain and headache, that is intense, deep pain never experienced before 3) nuchal rigidity or neck stiffness that is worse in flexion, Patient presents with fever, headache, photophobia, and nuchal rigidity. Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. 4/5) do Kernig/Brudzinski orthos, refer to ER for CSF tap. CSF tap shows increase in protein indicating viral infection, decrease in glucose indicates bacterial infection *Hypoglycemic headache* Age/sex Site Characteristics Provocation Lab - Answer Generalized headache caused by skipping meals, refer for fasting blood glucose labs *Post Concussive headache* Age/sex Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. Pitted nails - Answer Unguinal indentations, seen with psoriasis, *psoriatic arthritis* *Splinter hemorrhage* - Answer *Subacute bacterial endocarditis caused by a strep organism* *Beau's lines* - Answer *Transverse ridging associated* with acute *severs disease* *Paronychia* - Answer *Inflammation of the nail fold near the cuticle* *Clubbing* - Answer *Nail base has an angle greater than 180* associated with hypoxia (early), COPD (late). If see them do a heart and lung exam! *Koilonychia* - Answer Spoon nail, associated with *iron deficiency anemia*; "eat your iron with a spoon" Respiratory excursion - Answer Performed during palpation, place hands over the posterior ribs and have the patient take deep breaths Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. Tactile fremitus - Answer Palpable vibration, have the patient say 99 repeatedly; *increased with fluid like in pneumonia* decreased with air like in emphysema and pneumothorax, decreased with atelectasis and pleurisy because a sound barrier is created Resonate - Answer Normal tone over lung tissue with percussion Hyperresonant - Answer Increased air int the chest as in *emphysema or pneumothorax*, a finding with lung percussion Dull - Answer Increased density with percussion as in *pneumonia or atelectasis* Diaphragmatic excursion - Answer Done in the percussion portion of lung exam, if less than 3-5 cm the patient may have *pneumonia or a pneumothorax* Tracheal sounds - Answer Inspiration equal to expiration heard over the trachea Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. Bronchial sounds - Answer Expiration longer than inspiration heard over the manubrium Bronchovesicular sounds - Answer Inspiration equal to expiration, heard between the 1st-2nd ribs anteriorly and between the scapulae posteriorly Vesicular sounds - Answer Inspiration longer than expiration, heard over the remaining lung field, sound that is heard over the majority of the lung field Rales - Answer Clicking, bubbling, or rattling sounds in the lung, can be further describes as moist, dry, fine, and course. Associated with *Bronchitis* Rhonchi - Answer Resemble snoring. Associated with *bronchiectasis* Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. rales - Answer *Bronchitis* _____________: Hyperresonant decreased fremitus wheezing - Answer *Emphysema* _____________: Dull percussion decreased fremitus crackles (friction rub) - Answer *Pleurisy* ____________________: Hyperresonant Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. decreased fremitus decreased breath sounds - Answer Pneumothorax ________________: Dull percussion increased fremitus egophony Bronchophony whispered pectoriloquy crackles - Answer *Pneumonia* *Lobar pneumonia* what is it patient presentation Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. test findings - Answer *1* Consolidation of the lung, *2* patient presents with productive cough for 10 days with rusty brown sputum and fever. Percussion is dull; rales; increased tactile fremitus. *3* On X-ray see silhouette sign, air bronchogram, labs show increased WBC *Friedlander's pneumonia* what is it caused by patient presentation what population - Answer *1* caused by Klebsiella pneumonia *2* Productive cough with current red jelly sputum, *3* seen with older patients or immune-compromised patients *Pneumocystis carinii* Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. *2* patient presents with stabbing chest pain worsened by respiration, dry/non- productive cough *3* decreased respiratory excursion, decreased tactile fremitus, dull on percussion, friction rub is present; positive Schepelmann's test- pain on the convex side. No X-ray finding *Pneumothorax* what is it physical exam findings xray findings population - Answer *1* A ruptured lung causing air to become trapped in the pleural space. *2* Decreased chest expansion, decreased tactile fremitus, hyperresonant on percussion, decreased breath sounds; *3* on X-ray the lung field is darker than unaffected side; Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. *4* can occur in young, previously healthy individuals, spontaneous typical patient is a tall, healthy male *Atelectasis* what is it physical exam finding xray finding - Answer *1*Collapse of the lung that is usually the result of bronchial obstruction due to a mucous plug. *2*Presents with decreased tactile fremitus; dull on percussion; decreased chest expansion; decreased or absent breath sounds. *3* Mediastinal shift to the same side, on x-ray the affected lung is lighter. It sucks surrounding structures towards it. *Bronchiectasis* what is it Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. special test - Answer *1* Irreversible focal bronchial dilation that presents with a chronic, productive cough. *2* The special test that should be done is CT *Chronic bronchitis/COPD* defined by ______ signs main cause - Answer *1* Defined by a long-term cough with mucus. *2*Shortness of breath and wheezing. *3* Cigarette smoking is the main cause. Long exposure to other things such as chemical fumes, dust, and other substances may cause this. *Asthma* what is it/what type of reaction Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. *3* Patient presents with non-productive coughing more than 30 days, a febrile, dsypnea, and weight loss, clubbing of fingernails. *Costochondritis* what is it how does it develop signs similar to ____ - Answer *1* Inflammation of the cartilage connection between the ribs and sternum. *2* It develops as a consequence of physical activity and is worse with exercise. *3* The pain increases while taking a deep breath. There will be palpable tenderness as the 3rd, 4th, or 5th costosternal articulation. *4* Similar to Tietze syndrome which affects only one articulation and radiates pain. Can be chronic. Follow up is adjusting. *Herpes Zoster* Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. what is it pattern manifestation treatment - Answer Shingles *1* Painful vesicular rash following the course of a dermatome (usually a single nerve). *2* Primarily follows the dorsal root ganglion but when it does involve a cranial nerve it is most commonly seen at CN V. *3* Manifests when the immune system is down/weakened. *4* Treat with exposure to UV light to dry the vesicles and boost vitamin D, adjust which helps boost the immune system *Sarcoidosis* what is it Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. appearance population xray - Answer *1* Disease in which abnormal collections of inflammatory cells (granulomas) form as nodules *2* which most often appear in the lungs or lymph nodes. *3* Most commonly seen in African descent in the US. *4* On X-ray see bilateral hilar lymphadenopathy *Hodgkin's* what is it population presentation dx Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. cause - Answer "Bounding" increased cardiac output *exercise, anxiety, fever, hyperthyroidism* *Pulsus parvus* define cause - Answer Weak or thready; decreased stroke volume; *hypovolemia, aortic stenosis, CHF* *Pulsus alternans* define cause - Answer Alternates in amplitude; *left ventricular failure* *Pulsus bisferiens* Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. define cause - Answer Two strong systolic peaks separates by mid systolic dip (best felt at carotid artery); *aortic regurgitation, aortic stenosis* *Pulsus paradoxus* define cause - Answer Decreases amplitude on inspiration, increases with expiration (greater than 10 mmHg amplitude change); COPD, bronchial asthma, emphysema, pericardial effusion *Water hammer pulse* define cause - Answer A jerky pulse that is rapidly increasing and then collapsing Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. because of aortic insuffiency *Thrills* - Answer Vibration produced by turbulent blood flow within the heart (murmurs) Systole - Answer When the ventricles contract Diastole - Answer When ventricle rest and are filling S1 heart sound - Answer Closure of the AV valves (mitral and tricuspid) S2 heart sound - Answer Closure of the semilunar valves (pulmonary and aortic) S3 heart sound - Answer Ventricular Gallup; normal in children, young adults and athletes. In people over 40 it's the earliest sign of CHF S4 heart sound - Answer Atrial Gallup; related to stiffness of the ventricular myocardium to rapid filling Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. ARMS PT = D Murmurs during systole - Answer *A*ortic *S*tenosis *M*itral *R*egurgitation *P*ulmonic *S*tenosis *T*ricuspid Regurgitation ASMR PST = S *Patent ductus arteriosus* define what does it cause - Answer Failur of shunt to close between the *aorta and left pulmonary artery.* Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. Creates a *continuous/machinery like murmur* that can be heard in both phases of the heart cycle *Tetralogy of Fallot* define what does it create - Answer DRIP. *D*extraposition/ overriding of the aorta, *r*ight ventricular hypertrophy, *i*nter ventricular septal defect, and *p*ulmonic stenosis. Creates a *loud ejection murmur during systole and severe cyanosis*. *Coarctation of the aorta* define what does it cause associated with ____ - Answer *Constriction of the descending aorta* (usually distal to the left subclavian). Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. Causes *higher blood pressure in the upper extremity by 20 mmHg* when compared to the lower extremity. Associated with *Marfans Syndrome* *Subclavian steal syndrome* what is it classic case - Answer *1* Proximal stenosis of the subclavian artery. Seen in younger females who faint (syncope/drop attacks) when exercising. *2* Classic case is a 19 y.o. Female with episodes of syncope when exercising arms. *Left sided heart failure* most common cause is ____ 2nd most common cause is ____ Early Signs Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. associated with ____ in ascending aorta - Answer *1* An interruption of the intima allowing blood into the vessel wall with immediate "tearing" pain. It's an acute surgical emergency! *2* Associated with hypertension/arteriosclerosis with descending aorta *3* Marfan's in the ascending aorta. Marfans Syndrome - Answer An inherited connective tissue disorder with ventricular weakening and enlargement. Patient presents with tall stature, long fingers/limbs, lens subluxation, cardiovascular and lung problems *Angina pectoris* - Answer AKA coronary vasospasm. *Comes on with exertion and relieved with vasodilators under the tongue* *Printzmetal angina* - Answer aka atypical angina Angina that comes on with rest Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. *Myocardial infarction* what is it what increases 1st what increases 2nd what increases 3rd Order a ___ test - Answer ER referral. *1* Acute heart failure, comes on with rest, caused by atherosclerosis. *2*CK-MB increases first *3*SGOT/AST is second to increase *4* LDH is the last to increase *5* Order a stress test and EKG. *Aneurysm* - Answer Abnormal widening that involves all three layers; Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. defect in elastic-media tissues *P wave* - Answer Normal atrial depolarization *QRS complex* - Answer Depolarization of the ventricles, atria repolarization is hidden here *T wave* - Answer Repolarization of the ventricles *U wave* - Answer Repolarization of the papillary muscles *Increased PR interval* - Answer Prolonged AV nodal delay; primary heart block *Two P waves before QRS* - Answer Weinkbochs-block of bundle of HIS; secondary heart block *No QRS pattern* - Answer Complete heart block, no ventricular contraction Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. *2* Causes portal hypertension, ascites, esophageal varices. *Mallory Weiss syndrome* what is it due to what - Answer Coughing, tearing esophageal blood vessels and Hematemesis with palmar rash due to bile salts *Wernicke Korsakoff syndrome* - Answer Vitamin B/Thiamine deficiency from alcoholism that leads in dementia. Thiamine deficiency without alcoholism is known as ____ - Answer *Beri Beri* Hepatitis: *A* is from _____ *B* is from _____ *C* is from ____ - Answer *A* Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. From food via oral/fecal route, self limiting, not a carrier *B* From dirty needles/sexual contact, life long carrier, and most common to become liver cancer *C* From blood transfusions *Hepatitis* liver findings - Answer Liver may be tender and enlarged but the edge remains soft and smooth *Most common site for metastatic disease* - Answer liver cancer *Liver cancer* signs tumor marker Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. dx - Answer *1* Liver will be enlarge, with a hard irregular border, but not tender. *2* Alpha fetoprotein is a tumor marker specific for hepatocellular carcinoma. *3* Liver biopsy for definitive diagnosis. *Direct/Conjugated Bilirubin* solubility when is it increased increase in blood can cause ____ - Answer *1* Water soluble *2* increased most commonly with duct obstruction (gallstones), additionally hepatic disease and pancreatic cancer. *3* Increased amounts in the blood may cause bilirubin in the urine (urobilinogen) *Indirect/Unconjugated Bilirubin* Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. pain location chronically seen with ____ acute is an _____ signs labs - Answer *1* Epigastric pain going strait through the T10-T12 area like a knife. *2* Chronic is seen with alcoholism, *3* acute is a medical emergency. *4* Grey Turner sign [flank bleeding] and Cullen's [ecchymosis at umbilicus] *5* Lab tests: increased amylase and lipase Grey Turner Sign - Answer Bleeding into the flank presents as bluish discoloration in the flank area Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. Cullen's sign - Answer Periumbilical ecchymosis caused by intraperitoneal hemorrhage or seen with a ruptured ectopic pregnancy *Pancreatic cancer* usual location urine signs stool signs liver signs - Answer *1* Usually at the head of the pancreas *2* presents with dark urine *3* clay colored stools *4* jaundice Diabetes Mellitus - Answer Pancreas does not produce a sufficient amount of insulin to take the sugar out of the blood and transport it to the tissues of the body. T Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. he starved tissues force the breakdown of fats in order to obtain energy. Polydipsia, polyphagia, and polyuria seen. Labs: glucose tolerance test, fasting plasma glucose (FPG), HbA1C (glycosylated hemoglobin)...best test is fasting blood glucose. *DISH and diabetes have a 100% correlation (for boards)* *Insulin Dependent Type I diabetes* - Answer *Typical patient is juvenile, under 30 y.o. Usually thin* *Non-insulin dependent type II diabetes* - Answer *Adult over 40 y.o. Usually obese* *Diabetes Insipidus* - Answer Condition of the posterior pituitary gland in which there is *insufficient ADH* May have polydypsia, polyuria, but NOT polyphagia. (thirsty and peeing but not hungry) *Hiatal hernia* Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. stool dx test - Answer Most common type of peptic ulcer *1* Pain occurs 2 hours after eating *2* Patient may notice black/tarry stool (Digested blood) *3* Guaiac test: blood in the stool. *Pyloric stenosis* - Answer Projectile vomiting in the newborn *Gastric carcinoma* most common location often affects ____ - Answer *1* Most common in the lesser curvature. *2* Virchow's node: left supraclavicular lymph node involvement *Mononucleosis* cause and population Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. symptom presentation cell findings dx testing - Answer *1* Caused by the Epstein Barr virus and is seen in young adults (18-25 y.o.) *2* present with symptoms similar to the flu such as fever, headache, fatigue, lymphadenopathy in the cervical region, splenomegaly. *3* Atypical lymphocytes in the blood (Downey cells), Monospot, Heterophile agglutination, Paul Bunnell. Classic presentation is a college age athlete complaining of fatigue for weeks and flu like symptoms- must stop sports participation immediately due to risk of spleen rupture. *4* monospot aka Paul Bunnel Test *Osteopetrosis* aka Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. what is it what enlarges xray findings - Answer *1* AKA Marble Bone. *2* Bone marrow becomes sclerotic so RBCs are not made properly. [Hereditary absence of bone marrow] *3* Liver and spleen become enlarged. *4* On x-ray see bone within a bone in the early progression in late progression see sandwich vertebrae *Adynamic Ileus* - Answer gas in the intestines refferal pain for Small intestine - Answer peri-umbilical *Regional ileitis* aka Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. *2* most commonly seen in females. *3* Variable degrees of constipation and diarrhea in response to stress, Abdominal pain and gas relieved by bowel movements. *Appendicitis* what is it presentation labs special test - Answer *1* Dull periumbilical or epigastric pain that radiates to lower right quadrant (McBurney's point). *2* Presents with fever, nausea, vomiting, and anorexia, *3* labs show increased WBC (lots of immature WBC's). *4* Tests: rebound tenderness (peritonitis), Rovsking's sign, Psoas sign, obturator sign. Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. Special test is CT scan. *Diverticulitis* consequence of ____ what is it pain is ___ - Answer *1* Consequence of inadequate fiber in the diet. *2* Chronic constipation which causes small outpouchings within the colon that become infected. *3* Causes left lower quadrant pain *meckel's diverticulitis* - Answer outpouching of the ileum *zenker's diverticulitis* - Answer outpouching of the esophagus *Cushing's disease* what is it Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. sign - Answer Increased production of adrenal cortex hormone; hyperadrenalism; hypercortisolism. Moon face "pie face", buffalo hump (CT junction), pendulous abdomen with purple striae, hirsutism, weakness, and hypertension *Addison's disease* decreased ____ increased _____ signs - Answer *1* Decreased aldosterone; hypoaldrenalism, hypocortisolism. *2* Increased ACTH causes melanin deposition (hyper pigmented mouth and face, bronzed face). *3* Thin person, decreased blood pressure, weakness, fatigue, lethargy, nausea, vomiting, and hair loss may be seen *Pheochromocytoma* Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. what is it in pregnant is ____ urine signs other sign - Answer *HEP: hypertension, edema, massive proteinuria*; in pregnant women it is called pre-eclampsia. Waxy or fatty casts in urine. Can also have periorbital edema *Pyelonephritis* what is it patient usually has ___ urine signs - Answer *1* E. coli from UTI *2* patient usually has a fever Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. *3* WBC casts in urine *Polycystic kidney disease* what is it characterized by - Answer Inherited disorder characterized by many *bilateral renal cysts that increase renal size but reduce functioning renal tissue* *Urethritis* mcc in females mcc in males urine finding - Answer UTI. in females most commonly caused by E. coli. N Gonorrhea in males Nitrites in the urine *Cystitis* Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. what is it signs pain location - Answer *1* Non-infectious bladder inflammation *2* that causes burning, painful, and frequent urination with incontinence *3* Patient will also have suprapubic and low back pain. *Nephroblastoma* aka what is it patient age signs - Answer *1* AKA Wilm's tumor. *2* Malignant tumor of the kidney, Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. it appears as a bulge lateral and inferior to the external inguinal ring at the site of the femoral pulse *Endometriosis* what is it most common location presentation dx and treatment - Answer *1* Abnormal endometrial tissue found outside its normal location (myometrium, Fallopian tubes, peritoneum) *2* most commonly found in ovaries. *3* Presents with abdominal pain, back pain, menorrhagia, painful intercourse, and possible infertility. *4* Diagnosed and treated with laparoscopy Most common benign tumor in females - Answer *Uterine fibroids* Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. *Uterine fibroids* what is it presentation uterus findings - Answer Most common benign tumor in females. *1* Benign tumors of smooth muscle origin (leiomyoma). *2* Presents with heavy menstrual bleeding, pelvic pain, and painful intercourse. *3* Uterus will have painless nodules that are irregular and firm. *Pelvic inflammatory disease* what is it most commonly is a complication of ____ - Answer An infection of the upper female genital tract. It is the most common complication of an STD (chlamydia or gonorrhea) includes salpingitis (inflammation of the Fallopian tubes) Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. *Ectopic pregnancy* what is it presentation - Answer Pregnancy in which implantation occurs outside the endometrium/endometrial cavity. Presents with spotting, decreased blood pressure, decrease in HCG (compared to the 1st levels) *Normal pregnancy* presentation lab fx - Answer Increase HCG, nausea, weight gain, and breast tenderness. Blood test: human chorionic gonadotropin (HCG) is very high *Hydatiform mole* what is it Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. *4* Presents with nipple retraction, bleeding, orange peel appearance, and dimpling. *5* Metastasis to the axillary vial the lymphatic system and will most likely be lytic when seen in the bone *Varicocele* - Answer *Tortuous dilation of the spermatic veins* "Bag of worms" feeling upon palpation that diminishes from standing to supine *Spermatocele* - Answer *A fluid filled mass in the epididymis* It is a painless, movable, pea sized lump located superior and posterior to the testicle. It transluminates light because it's fluid filled *Hydrocele* - Answer *Excess accumulations of water in the testicle* It feels swollen, painless, heavy, and tight. The ability to palpate above the mass distinguishes it from a scrotal hernia. Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. It transluminates. *Epididymitis* - Answer Usually a consequence of an STD. The scrotum is enlarged and tender but tenderness may be relieved somewhat by raising the testicle *Testicular cancer* age sign mc type - Answer *1* Most common form of cancer in males 20-34 yo. *2* Painless nodule appears on or in the testicle. *3* Most common type is a seminoma. Does not transluminate light. Boards Part 2 & 3 Irene Gold (General Diagnosis Over 950 Correctly Defined Reviews. *Benign prostatic hyperplasia* - Answer Enlarged, non-tender, firm, smooth, with loss of the median sulcus. Special test is the digital exam *Prostatitis* - Answer Boggy, soft, enlarged, and tender, urinary problems such as increased urgency *Prostatic carcinoma* - Answer Posterior lobe is hard, nodular, painless, and enlarged. Most common place to metastisize is to the lumbar spine via batson's plexus and is blastic metastasis. *Cranial Nerve I* name function - Answer *1* Olfactory nerve. *2* Sensory for sense of smell *Anosmia* - Answer Lost sense of smell *Parosmia* - Answer Distorted sense of smell