Term
| What respiratory rate corresponds to bradypnea and tachypnea? |
|
Definition
Below 10/min = bradypnea.
Above 20/min = tachypnea. |
|
|
Term
| What conditions lead to orthopnea? |
|
Definition
| CHF, diaphragmatic paralysis, SVC syndrome and mediastinal mass. |
|
|
Term
| What is the Kussmaul pattern of respiration? Causes? |
|
Definition
| Rapid, deep respirations. Causes include metabolic acidosis, DKA, ethanol and ketoacidosis. |
|
|
Term
| What is biot pattern of respiration? Cause? |
|
Definition
| periodic apnea intermixed with rapid deep breathing. Caused by brainstem damage. |
|
|
Term
| What is the Cheyne-Stokes pattern of respiration? Cause? |
|
Definition
| Periodic, repetitive apnea. Periods of breathing, the depth increases with each breath. Caused by CHF. |
|
|
Term
| What is the Sleep apnea pattern of respiration? |
|
Definition
| Intermittent period of apnea to 20 seconds while asleep. Caused by obesity or a retrosternal goiter. |
|
|
Term
| Describe the normal tracheal findings on inspection. |
|
Definition
| Trachea is slightly tilted to right. As a result, the clavicular insertion of right Sternomastoid is slightly more prominent and the space between trachea and sternomastoid is smaller compared to left. |
|
|
Term
| Describe the difference between pull and push abnormal lung findings. |
|
Definition
| Pull is a loss of lung volume and push is when there are space occupying masses. |
|
|
Term
| Describe the tracheal deviation seen with tension pneumothorax, massive pleural effusion and atelectasis. |
|
Definition
Tension pneumothorax = trachea is pushed away from side of pneumothorax.
Pleural effusion = trachea is pushed away from the side of effusion.
Atelectasis = trachea is pulled toward the side of atelectasis. |
|
|
Term
| Describe the changes seen on percussion with tension pneumothorax, massive pleural effusion and atelectasis. |
|
Definition
Tension pneumothorax = tympany.
Pleural effusion = dullness.
Atelectasis = dullness. |
|
|
Term
| What vertebra can be used to estimate the height of the ileum? |
|
Definition
|
|
Term
| What is the level of the carina for the anterior and posterior? |
|
Definition
| Anterior is the level of the 3rd intercostal space and the posterior is at the level of T4. |
|
|
Term
| Which mainstem bronchus is more horizontal and is shorter? |
|
Definition
|
|
Term
|
Definition
| It is seen with chronic pulmonary disorders and is caused by peripheral trapping and clumping of large immature platelets that promote angiogenesis and bone growth. |
|
|
Term
| Describe pectus carinatum, pectus excavatum, and kyphoscoliosis. |
|
Definition
Pectus carinatum = thick AP diameter but narrow shoulder and body width (pigeon-chested).
Pectus excavatum = sunken in chest.
Kyphoscoliosis = twisted spine. |
|
|
Term
| What is the normal range of chest expansion in inches? |
|
Definition
|
|
Term
| How will non obstructed consolidation, obstructed consolidation, pleural effusion and lobectomy affect tactile fremitus? |
|
Definition
| Non-obstructed consolidation will lead to increased TF. Obstructive will lead to decreased TF. Pleural effusion will lead to decreased TF will a thin rim of increased TF over the pleural effusion. Lobectomy will have absent TF. |
|
|
Term
| What percentage of the lung is air? |
|
Definition
|
|
Term
| What is the normal range for diaphragmatic excursion? |
|
Definition
|
|
Term
| What conditions could lead to dullness on lung percussion? |
|
Definition
| Dullness: (Mass, Atelectasis, Consolidation, Pleural effusion). |
|
|
Term
| What conditions could lead to hyper-resonance on lung percussion? |
|
Definition
| Hyper-resonance: (Emphysema, Asthma, Pneumothorax, Blebs). |
|
|
Term
| What conditions could lead to decreased diaphragmatic excursion? |
|
Definition
| Decreased diaphragmatic excursion: (Emphysema, paralysed diaphragm) |
|
|
Term
| What are the two physiologic reasons for lung percussion dullness? |
|
Definition
| consolidated lung tissue and effusion |
|
|
Term
| What are the two physiologic reasons for hyper-resonance? |
|
Definition
| obstructive lung disease and pneumothorax |
|
|
Term
| How deep can percussion measure? |
|
Definition
|
|
Term
| Describe where you hear bronchial and vesicular breath sounds. |
|
Definition
| Breath sounds heard over the tracheobronchial tree are called bronchial breathing and breath sounds heard over the lung tissue are called vesicular breathing. |
|
|
Term
| Where are the only spots that bronchial breaths are heard on auscultation? |
|
Definition
| trachea, right sternoclavicular joint and posterior right interscapular space.. |
|
|
Term
| Describe the differences heard on auscultation between bronchial and vesicular breath sounds. |
|
Definition
Bronchial = sounds over the trachea have a higher pitch, louder, inspiration and expiration are equal and there is a pause between inspiration and expiration.
Vesicular = lower pitched and softer than bronchial breathing. Expiration is shorter and there is no pause between inspiration and expiration. |
|
|
Term
| Are breath sounds louder in the bases or apices in the erect position? |
|
Definition
| Louder in the bases in the erect position |
|
|
Term
| Which auscultation findings are usually pathologic? |
|
Definition
| wheezes, crackles, rales and pleural friction rubs. |
|
|
Term
| Describe where the lung abnormality is with crackles, rhonchi and stridor. |
|
Definition
Crackles = terminal airway disease (interstitial/alveolar edema).
Rhonchi = proximal airway disease.
Stridor = upper airway obstruction. |
|
|
Term
| What is the typical clinical presentation of a child with epiglottitis? How should you handle this situation? |
|
Definition
| The child will sit forward and drool as the tender epiglottis prevents swallowing saliva. If you see this, call anesthesia immediately. Do not attempt to visualize or manipulate the epiglottis, as even small perturbations can cause immediate laryngeal spasm and death. |
|
|
Term
| Symptoms of pneumonia without signs of consolidation and/or a neg CXR suggests? |
|
Definition
| atypical pneumonia (Mycoplasma, Chlamydia, Legionella). |
|
|
Term
| Is hilar lymphadenopathy with pneumonia normal for children? Adults? |
|
Definition
| Hilar lymph node enlargement is normal in children but NOT in adults |
|
|
Term
| Should you use a CXR to confirm resolution of a pneumonia? |
|
Definition
|
|
Term
| Describe the PE findings with a pleural effusion. (percussion, auscultation, special test and fremitus) |
|
Definition
a. Dullness to percussion.
b. Absence of breath sounds.
c. No egophony, bronchophony or whisper pectoriloquy.
d. Fremitus is absent (no vibration). fremitus is very useful in distinguishing an effusion from consolidation as the cause of an area of dullness to percussion. |
|
|
Term
| What are some common conditions that cause wheezing? |
|
Definition
| Aspiration , Asthma, Certain drugs, COPD, Endobronchial tumors, Endotracheal tumors, Inhaled irritants, Pulmonary edema, Tracheal stenosis, Viral tracheobronchitis, Vocal cord dysfunction |
|
|
Term
| What are the S&S of a pink puffer? |
|
Definition
| COPD, pursed lips, thin, tachypnea, with dyspnea |
|
|
Term
| What are the S&S of a blue bloater? |
|
Definition
| COPD, cough with sputum x 3 months min, blue due to lack of Oxygen, peripheral edema, dyspnea, prone to right sided heart failure. |
|
|
Term
| Does pink puffer or blue bloater have a better prognosis? |
|
Definition
| Pink puffer has a better prognosis. |
|
|
Term
| Describe the sputum seen with bronchiectasis and lung abscesses. |
|
Definition
| Can be purulent and offensive and will be streaked with blood. |
|
|
Term
| Describe the sputum seen with pulmonary edema. |
|
Definition
|
|
Term
| Describe the sputum seen with pulmonary TB/Neoplasm. |
|
Definition
| Can be any type of sputum. |
|
|
Term
| Describe the sputum seen with chronic bronchitis. |
|
Definition
| Scant, mucopurulent, mucoid with flecks of yellow/green pus. |
|
|
Term
| Describe the sputum seen with pneumonia (Pneumococcal or strep pneumonia). |
|
Definition
|
|
Term
| Describe the sputum seen with pseudomonas. |
|
Definition
| Moldy, necrotic tissue odor. |
|
|
Term
| Describe the sputum seen with Klebsiella pneumonia. |
|
Definition
| Thick ,Current-Jelly, Gelatinous, Brick red, Laced with pus |
|
|
Term
| What immunoglobulin is affected with allergic asthma? |
|
Definition
|
|
Term
| What is the cause of exercise induced asthma? |
|
Definition
| Release of leukotrienes from bronchial mast cells. |
|
|
Term
| Where does congenital emphysema affect most commonly? What are the physiologic changes that occur with emphysema? |
|
Definition
| Congenital emphysema usually affects the upper lobes and the physiologic changes are that there is a loss of alveoli. |
|
|
Term
| Name and describe the neurologic syndrome that commonly occurs with a cancer in the upper lobe of the lungs. |
|
Definition
| Horner's syndrome - ptosis, miosis and facial anhidrosis. |
|
|
Term
| Rank the top 3 most common types of lung cancer. |
|
Definition
| Squamous cell (40%), Adenocarcinoma (30%) and Small cell (20%). |
|
|
Term
| Describe the most common location for lung squamous cell, adenocarcinoma and small cell. |
|
Definition
| Squamous = upper lobes and mainstem bronchus. Adeno = peripheral lung fields. Small = peripheral lung fields and possibly in the central. |
|
|
Term
| Describe the growth rate for lung squamous cell, adenocarcinoma and small cell. |
|
Definition
| Squamous and adenocarcinoma grow slow (adeno is the slowest) and small cell grows rapidly. |
|
|
Term
| Describe the metastatic tendencies lung squamous cell, adenocarcinoma and small cell. |
|
Definition
| Squamous is late to metastasize, Adenocarcinoma is early to metastasize and small cell has usually metastasized before it is diagnosed. |
|
|
Term
| What are "smoker's fingers"? |
|
Definition
| yellow-brown staining of the finger nails |
|
|
Term
| What does spirometry measure? Uses? |
|
Definition
| The amount and rate of air a person breathes in order to diagnose illness or determine progress in treatment. |
|
|
Term
| Describe what happens in the lungs with obstructive pulmonary diseases and how they affect residual volume and functional residual capacity. |
|
Definition
| Obstructive pulmonary conditions cause the patients to have hyperinflated lungs due to the trapping of air in the lungs. The residual volume and the functional residual capacity are both elevated. |
|
|
Term
| Describe what happens in the lungs with restrictive pulmonary diseases and how they affect TLC, inspiratory capacity and vital capacity. |
|
Definition
| The lungs are less compliant and cannot expand normally. TLC, inspiratory capacity and vital capacity are all reduced. |
|
|
Term
| Describe the differences in vital capacity (max amount of air expired after max inspiration) for obstructive vs. restrictive pulmonary disorders. |
|
Definition
| Obstructive will have a normal or decreased VC and restrictive will definitely have a decreased VC. |
|
|
Term
| Describe the differences in FEV1 (forced expiratory volume in 1 sec) for obstructive vs. restrictive pulmonary disorders. |
|
Definition
| Obstructive will definitely be decreased and restrictive can be normal or decreased. |
|
|
Term
| Describe the differences in residual volume and total lung capacity for obstructive vs. restrictive pulmonary disorders. |
|
Definition
| They can be normal or increased for obstructive and they will be decreased for restrictive. |
|
|
Term
| Describe the differences in the RV/TLC ratio for obstructive vs. restrictive pulmonary disorders. |
|
Definition
| Obstructive will be increased and restrictive can be normal or increased. |
|
|
Term
| What are some common causes of restrictive pulmonary disorders? |
|
Definition
| PAINT - Pleural (effusions or plaques), Alveolar (pulmonary alveolar proteinosis), Interstitial (fibrosis), Neuromuscular (ALS - Amyotrophic lateral sclerosis or Lou Gehrig disease, Myasthenia gravis) and Thoracic (Scoliosis). |
|
|
Term
| What are some common causes of obstructive pumonary disorders? |
|
Definition
| Asthma, COPD, Tumors, Foreign bodies and Scarring/Strictures. |
|
|
Term
| Describe the procedure and use of incentive spirometry. |
|
Definition
| Patient exhales completely and then inhales smoothly until max inhalation is achieved. used in post-op, in-patients, ICU and as bronchial prophylaxis to maintain airway patency and to prevent/correct atelectasis. |
|
|
Term
| Why are "spacers" efficient when delivering inhalation therapy? |
|
Definition
| They slow down aerosol coming from the inhaler and less of the drug hits the back of the mouth and more gets to the lungs. Less medication is needed for an effective dose to reach the lungs which results in fewer side effects. |
|
|
Term
| What are the 5 main functions of the skin? |
|
Definition
| Protect the internal structures, prevent the entry of microorganisms, regulate temperature, excretion, and production of vitamin D. |
|
|
Term
| Describe the layers of the epidermis from superficial to deep. |
|
Definition
| Corneum, lucidum, granulosum, spinosum and basale. |
|
|
Term
| Describe the layers of the dermis from superficial to deep. |
|
Definition
| Papillary and then reticular. |
|
|
Term
| Which layer of skin contains the Pacinian corpuscles (sensory receptors), sweat glands, lymph vessels, and hair follicles? |
|
Definition
| Reticular layer of the Dermis. |
|
|
Term
| Which layer of the skin creates "fingerprints"? |
|
Definition
| The papillary layer of the dermis. |
|
|
Term
| Which layer of the epidermis is found only in the palms and soles of the feet? |
|
Definition
|
|
Term
| Describe the three types of sweat glands (eccrine, apocrine and sebaceous) and what they secrete. |
|
Definition
Eccrine = most common sweat gland that is found throughout the body and secretes sweat to maintain body temperature.
Apocrine = found primarily in the axilla and anal region and become active during puberty and secrete pheromones.
Sebaceous = found surrounding hair follicles and they secrete sebum to keep hair and skin moist. |
|
|
Term
| Describe the differences in the two types of body hair (vellus and terminal). |
|
Definition
Vellus – firm delicate hair covers most of body, inconspicous
Terminal – Coarser, thicker and pigmented. Scalp, eyebrows and genital hair. |
|
|
Term
| Define the nail matrix, eponychium and lunula. |
|
Definition
| Matrix is the proximal nail fold. Eponychium is the cuticle. Lunula is the white half moon part of the nail base. |
|
|
Term
| What are the 4 pigments that determine skin color? |
|
Definition
| Melanin, carotene, oxyhemoglobin and deoxyhemoglobin. |
|
|
Term
| What are the 9 major groups of dermatological diseases based on morphology? |
|
Definition
| Eczema/dermatitis, maculopapular, papulosquamous, vesiculobullous, pustular, urticaria, nodular, telangiectasias and hyper/hypomelanosis. |
|
|
Term
| What is skin with decreased turgor a sign of? |
|
Definition
|
|
Term
| What is skin with decreased mobility a sign of? |
|
Definition
|
|
Term
| Describe the distribution of lesions that occur in: annular, arcuate, bizarre, confluent, discoid, iris and reticular formations. |
|
Definition
Annular – ring shaped.
Arcuate – partial ring.
Bizarre- irregular.
Confluent- run together.
Disccoid- disc shape with no central clearing.
Iris – circle within a circle.
Reticular – marble like. |
|
|
Term
| What are the ABCDE's of melanoma? |
|
Definition
| Asymmetry, Border irregularity, Color variation, Diameter larger than 6mm, Elevation. |
|
|
Term
| :Small flat nonpalpable spot, up to 1 cm, freckles. |
|
Definition
|
|
Term
| :larger flat nonpalpable spot, more than 1 cm, vitiligo, café au lait spots |
|
Definition
|
|
Term
| :palpable, elevated solid mass up to 1 cm |
|
Definition
|
|
Term
| :well circumscribed hyperpigmented papule or macule, known as a birthmark or a mole. |
|
Definition
|
|
Term
| :Palpable, elevated solid mass greater than 2 cm |
|
Definition
|
|
Term
| :Superficial elevations of the skin filled with fluid, smaller than 1 cm |
|
Definition
|
|
Term
| :Superficial elevations of the skin filled with fluid, greater than 1 cm |
|
Definition
|
|
Term
| :Superficial elevations of the skin filled with pus |
|
Definition
|
|
Term
| :Localized accumulation of purulent material in the dermis |
|
Definition
|
|
Term
| :Plugged opening of sebaceous gland |
|
Definition
|
|
Term
| :Necrotizing form of inflammation of a hair follicle |
|
Definition
|
|
Term
| :coalescence of several furuncles |
|
Definition
|
|
Term
| :Small harmless tumors of the skin caused by human papilloma virus, gray to flesh colored nodules raised from the skin surface, and covered with rough, hornlike projections. |
|
Definition
|
|
Term
| :Conical structure of keratin pointing to the dermis, due to pressure on the skin. |
|
Definition
|
|
Term
| :thickening of epidermal keratin due to pressure and friction |
|
Definition
|
|
Term
| :exfoliated epidermis, (dandruff, psoriasis) |
|
Definition
|
|
Term
| :dried residue of pus, serum or blood |
|
Definition
|
|
Term
| :roughening and thickening of epidermis witht accentuation of the normal skin lines |
|
Definition
|
|
Term
| :Pink or red discloration of the skin |
|
Definition
|
|
Term
:Reddish – purple macules 1-3mm
:Reddish – purple macules > 3mm |
|
Definition
|
|
Term
| :Purple or purplish blue macules, fade over time, “Black & Blue” marks |
|
Definition
|
|
Term
| :Fine, irregular blood vessels |
|
Definition
|
|
Term
| :Central red macules with radiating spider like arms |
|
Definition
|
|
Term
|
Definition
|
|
Term
| :Replacement of destroyed dermis with fibrous tissue |
|
Definition
|
|
Term
| :Elevated scar that grows beyond wound |
|
Definition
|
|
Term
| :Minute, slightly raised tunnel in epidermis, (Scabies) |
|
Definition
|
|
Term
| :Linear crack from epidermis to dermis |
|
Definition
|
|
Term
:Superficial linear traumatized area
(Abrasion, scratch) |
|
Definition
|
|
Term
| :Thinning of the skin, (Striae) |
|
Definition
|
|
Term
| :Loss of part of epidermis, (Vesicle rupture) |
|
Definition
|
|
Term
| :Loss of epidermis and dermis |
|
Definition
|
|
Term
| :>10mm, purple, palpable (ecchymosis is non-palpable) |
|
Definition
|
|
Term
| Describe stage I-IV pressure ulcers. |
|
Definition
I - reddness or purple shade to skin with increased warmth or coolness.
II - partial thickness skin loss involving epidermis and/or dermis.
III - Full thickness skin loss but it does not extend through the fascia.
IV - Full thickness skin loss and destruction of muscle and/or bone. |
|
|
Term
| What is a patch test used to diagnose? |
|
Definition
| It is used to diagnose if someone is allergic to certain stimuli. |
|
|
Term
|
Definition
| When you scrape the skin and someone becomes swollen, itchy and red. |
|
|
Term
|
Definition
| bleeding after psoriasis is scraped off |
|
|
Term
|
Definition
| blisters that spread upon pressure to the skin |
|
|
Term
| What is Paring Hyperkeratotic Lesions used to differentiate? |
|
Definition
| Differentiation of warts and calluses |
|
|
Term
| What does the Tzank smear detect? What kind of stain is used? |
|
Definition
| Looks for Tzanck cells which are indicative of herpes or varicella. use Giemsa or Wright stain. |
|
|
Term
| Describe Moh's procedure. |
|
Definition
| Highly specialized method of excision where you debulk obvious tumor, then excision is performed in stages, allows for the smallest surgical margins and defect. |
|
|
Term
| What is cryosurgery typically reserved for? |
|
Definition
| Used for small, superficial, nonmalignant lesions (warts) |
|
|
Term
| What are the two stages of tanning due to sun exposure? |
|
Definition
| Immediate pigment darkening due to UVA and a photochemical change in melanin and then within 72 hours new malanin is synthesized. |
|
|
Term
| What time of day should you avoid sun exposure? |
|
Definition
|
|
Term
| What are the effects of a cool solution and Tepid solution wet dressing? |
|
Definition
Cool solution = anti-inflammatory effect
Tepid solution = debridement effect |
|
|
Term
| What is the major use of topical corticosteroids? |
|
Definition
| inflammatory skin disorders |
|
|
Term
| What are some risks of topical steroid use? |
|
Definition
| Atrophy, telangiectasia, purpura, perioral dermatitis, rosacea, masking of initial lesion, rebound tachyphylaxis, pigmentation abnormalities and systemic absorption. |
|
|
Term
| Describe the alopecia associated with androgen-mediated. |
|
Definition
| frontal, temporal and occipital hair loss. |
|
|
Term
| Describe the hair loss seen with arterial insufficiency and venous stasis. |
|
Definition
| Loss of hair in the extremities |
|
|
Term
| Describe the alopecia seen with alopecia areata. |
|
Definition
| patches of hair loss but it regrows |
|
|
Term
| What is Queen Anne's sign of alopecia? |
|
Definition
|
|
Term
| What is Trichotillomania pattern of alopecia? |
|
Definition
| Habitual pulling out of hair. |
|
|
Term
| What is female pattern alopecia? |
|
Definition
| Diffuse and incomplete alopecia |
|
|
Term
| :increased hair growth in androgen sensitive areas. |
|
Definition
|
|
Term
| :Spooning, Nail plate thins and becomes inverted, Associated with iron deficiency anemia |
|
Definition
|
|
Term
| What is nail pitting associated with? |
|
Definition
|
|
Term
| What are white or (Terry's) nails a sign of? |
|
Definition
| heart failure or liver disease |
|
|
Term
| What are blue-green nails a sign of? |
|
Definition
|
|
Term
| What are brown-yellow nails a sign of? |
|
Definition
| Ingestion of phenindione (anticoagulant, vitamin K antagonist) |
|
|
Term
| What are brown-black colored nails a sign of? |
|
Definition
Onychomycosis/Paronychia
Fungal infection |
|
|
Term
| What are nail splinter hemorrhages a sign of? |
|
Definition
| usually trauma but can be endocarditis |
|
|
Term
| Describe Beau's lines and Mee's/Muercke's lines of the nails. Associated with? |
|
Definition
| Beau's = transverse depressions associated with a severe illness. Mee's/Muercke's = transverse lines associated with an acute or severe illness. |
|
|
Term
| What angle between the nail base and the finger is indicative of clubbing? What causes clubbing? |
|
Definition
| Angle over 180 degrees, causes by chronic hypoxia. |
|
|
Term
| Describe the difference between eponychium, onychia and paronychia. |
|
Definition
| Eponychium is pus in the proximal fold. Onychia is swelling beneath the entire nail plate. Paronychia is pus in the lateral or medial fold. |
|
|
Term
| Any “splinter hemorrhage” that starts in the germinal matrix and grows outward without any normal bed between the proximal end and the germinal matrix think...? |
|
Definition
|
|
Term
| White nail plates, think...? |
|
Definition
| severe liver disease or heart failure |
|
|
Term
| How do hypothyroidism, thyrotoxicosis and scleroderma each affect skin texture? |
|
Definition
Soft: (Thyrotoxicosis).
Tight: (Scleroderma).
Rough: (Hypothyroidism). |
|
|
Term
| :Typical erythematous plaques topped by a silver scale. Seen MAINLY in the knees, elbows, scalp, forearms, lumbosacral regions, hands, and feet. |
|
Definition
|
|
Term
| What is Keobner Phenomenon? |
|
Definition
| Lesions induced in areas of local trauma, such as scratches or surgical scars |
|
|
Term
| :Small drop-like plaques with scales developed after a child having streptococcal pharyngitis |
|
Definition
|
|
Term
| Where is the rash with childhood atopic dermatitis most commonly seen? |
|
Definition
| Mainly on the flexural surfaces. |
|
|
Term
| :Marked thickening of the skin seen in areas of atopic dermatitis. |
|
Definition
|
|
Term
:Newest topical antibiotic. Requires less application therefore increases compliance.
*2x/day x 5 days vs. the recommended 3x/day x 7 days like with mupirocin, bacitracin or neosporin . |
|
Definition
|
|
Term
| :Chronic cracking, oozing, and scaling that develop on the hands and soles of the feet |
|
Definition
|
|
Term
| :“coin-shaped” eczema-round to oval shaped lesions typically over the extensor thighs or abdomen |
|
Definition
|
|
Term
| :skin disorder affecting the scalp, face, and trunk causing scaly, flaky, itchy, red skin. |
|
Definition
|
|
Term
| :a large, pink, red, brown patch (which may be scaly in texture) on the chest or back. This first patch is called the herald patch or the mother patch. One to 2 weeks after the appearance of the mother patch, more pink patches will appear along the skin folds of the trunk. After a period of 2 to 10 weeks, the rash disappears on its own (spontaneously). |
|
Definition
|
|
Term
| :a very common genetic follicular condition that is manifested by the appearance of rough bumps on the skin |
|
Definition
|
|
Term
| :a common skin condition mostly occurring in children and usually seen as dry, fine-scaled, pale patches on the face. It is self-limiting and usually only requires use of moisturiser creams. |
|
Definition
|
|
Term
:Most common type of allergic contact dermatitis in the United States
Presents as linear streaks of erythematous papules and vesicles caused by direct contact with the sap of poison ivy, poison oak or poison sumac from leaves, stems, or roots |
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Definition
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Term
| How is the diagnosis of Tinea Pedis made? |
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Definition
| By the presence of hyphea on KOH prep. |
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Term
| What condition is seen with the "slapped cheek" rash? |
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Definition
|
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Term
| Cause of Erythema Infectiosum? |
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Definition
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Term
| Cause of Roseola? Describe it. |
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Definition
| Human Herpes Virus type 6. It is an exanthem of rose-pink macules. |
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Term
| :Infected person has a fever lasting 2-4 days followed by a cough, runny nose and red watery eyes. A rash then appears on the face and head which spreads to the torso, hands and feet. |
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Definition
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Term
| When can measles be transmitted? |
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Definition
| 4 days prior to and 4 days after the appearance of the rash. |
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Term
| When is Varicella contagious? |
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Definition
| 48 hours prior to rash until the lesions have crusted over. |
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Term
| :Flat top violaceous papules of varying sizes and shapes overlying the anterior shin are typical. A network of gray lines, called Wickham’s striae are seen on surface of the lesions. |
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Definition
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Term
| :Multiple pruritic papules, some excoriated and a few with central black dots, Seen on the wrist and dorsum of the hand with pathognomonic burrows |
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Definition
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Term
| Disease with the characteristic "Bull's Eye" rash. |
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Definition
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Term
| :signs and symptoms of the disease include sudden onset of fever, headache, and muscle pain, followed by development of maculopapular/petechial rash. The disease can be difficult to diagnose in the early stages, and without prompt and appropriate treatment it can be fatal. |
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Definition
| Rocky Mountain Spotted Fever |
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Term
| Volcano lesion due to a hole in the flesh due to gangrenous tissue is seen with what condition? |
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Definition
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Term
| :rough, sandpaper-like plaques occurring on sun-exposed surfaces |
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Definition
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Term
| :Translucent, pearly nodule, depressed center and raised borders, may ulcerate, seen with fair skin, on the face and over 40. |
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Definition
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Term
| :Red scaling, crusting nodule or plaque that can ulcerate and bleed, grows more quickly, and can metatasize to lymph nodes and other organs, May develop from actinic keratosis, seen in fair skinned individuals over 60 on the face or other sun exposed areas. |
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Definition
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Term
| :Irregularly colored plaque with sharp notches and variation of pigment, If untreated, can have fatal metastases, associated with a family history, fair skin and prolonged sun exposure. |
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Definition
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Term
| What are the 4 types of melanoma and which is the most common? |
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Definition
| Superficial spreading, Nodular, Lentigo maligna and Acral lentiginous. Superficial spreading is the most common (70%). |
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Term
| :Dark blue purple macules, papules, nodules and plaques, Start light colored and coalesce into darker lesions, Widely disseminated on legs, trunk, arms, neck and head, Most frequent neoplasm occuring in AIDS patients |
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Definition
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Term
| Which degree burn corresponds to: redness, tenderness, pain, no blistering, and healing within a few days w/ no scar. |
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Definition
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Term
| What degree burn corresponds to: epidermis and superficial dermis involvement, pink/moist/soft skin, thin blisters, tender skin, heals in 2-3 weeks without scarring |
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Definition
| Superficial partial-thickness 2nd degree burn |
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Term
| What burn degree corresponds to: epidermis and lower dermis involvement, red/blanched white skin with thick blisters, healsin 3-6 weeks with possible scarring. |
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Definition
| Deep partial-thickness 2nd degree burn |
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Term
| What degree of burn corresponds to: full thickness burn that destroys the epidermis and dermis, white/leathery skin with underlyign clotted vessels, skin grafting is needed. |
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Definition
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Term
| What burn degree is characterized by: full thickness burn extending into the muscle of bone, requires hospital admission. |
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Definition
|
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Term
| :Hyperpigmentation and leathery thickening of the skin are seen on the neck and in the axilla or other skin folds |
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Definition
|
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Term
| What is the first line treatment for Acne vulgaris? |
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Definition
| Differin cream or gel 0.1%(Retinoid) |
|
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Term
| :hyperpigmentation, commonly of the face of women taking oral contraceptives, anticonvulsants or that are pregnant. |
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Definition
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Term
| A 62 year old school principal with a hx of COPD presents to the ER for evaluation of shortness of breath. You note that his lips, oral mucosa, and tongue are blue. You diagnose a COPD exacerbation. The discoloration of the lips, oral mucosa, and tongue is referred to as: |
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Definition
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Term
| A 30 year old janitor presents to your clinic for evaluation of increased weight. He drinks a fifth of vodka daily. He has used intravenous drugs in the past but is now “clean.” His sclerae and skin have a yellowish tinge. He has a large abdominal girth. You diagnose him with liver dysfunction. What is the discoloration of his skin called? |
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Definition
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Term
| A 72 yo retired secretary is brought to the clinic by her daughter. The daughter is concerned because her mother seems to be more confused; she has gained more weight, but her appetite has decreased, and she seems to be more “swollen” in general. You obtain blood tests and diagnose her with profound hypothyroidism. On examination of the skin, you expect it to feel. |
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Definition
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Term
A 42 yo receptionist presents to your office for evaluation of multiple moles (nevi). She used to sunbathe a lot when she was younger and went to tanning salons regularly until 2 years ago. You are educating her about melanoma. When evaluating a mole, all of the following characteristics are important to note EXCEPT:
Asymmetry
Irregular borders
Color variation
Diameter smaller than 6 mm
Elevation |
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Definition
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Term
| A 52 yo office worker presents to your office for evaluation of a bump on his face. It appeared 1 month ago and is growing. He denies fever, chills, or itching. Physical examination reveals a 0.4-cm nodule with a depressed center and a firm, elevated border that is flesh-colored. Based on this information, what is your most likely diagnosis? |
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Definition
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Term
| :Smallest living free organisms, Grow in cell-free media and produce disease without intracellular penetration, Have a cell membrane but no cell wall |
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Definition
|
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Term
| 4 major species of Mycoplasmas? |
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Definition
M. pneumoniae
M. hominis
M. urealyticum
M. fermentans |
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Term
|
Definition
| Erythromycin and Tetracycline |
|
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Term
| :small bacterial organisms that are obligate intracellular parasites and usually require a vector, responsible for Q fever. |
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Definition
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Term
| What 4 organisms make up the spirochetes? |
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Definition
| Treponema, Leptospira, Borrelia and Spirillium. |
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Term
| What disease is caused by Treponema? Borrelia? |
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Definition
Treponema = syphillis, YAWS
Borrelia = Lyme disease |
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Term
| How are anaerobic bacteria often identified in the lab? |
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Definition
| foul odor and presence of gas |
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Term
| What is found in the cell wall of Gram negative bacteria? What 3 major species of bacteria are gram negative? |
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Definition
| LPS in the cell wall. Haemophilus, Pseudomonas and Enterobacteria are gram negative. |
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Term
| What are some examples of enterobacteria? |
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Definition
| E.coli, Klebsiella, Enterobacter, Serratia, Salmonella, Shigella and Proteus. |
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Term
| How do gram positive bacteria and gram negative look on gram stain? |
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Definition
| Gram positive are deep purple, gram negative are pink |
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Term
| What are the 2 gram negative cocci? |
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Definition
|
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Term
| What are some common gram positive bacteria? |
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Definition
| Staphylococcus, Streptococcus, Clostridium, Bacillus, Listeria, Corynebacteria |
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Term
| What main 2 bacteria are IV drug users susceptible to? |
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Definition
|
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Term
| What test should you use to diagnose mycobacteria? |
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Definition
|
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Term
| What should you use to diagnose fungal infections? |
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Definition
|
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Term
| :Unusual proliferation of lymphocytes into the bloodstream due to Epstein-Barr virus, symptoms include pharyngitis, lymphadenitis, abdominal pain, fever and malaise. |
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Definition
|
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Term
| :sore throat, malaise, fever, whitish exudates that appear on the tonsils and later become a grayish membrane. |
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Definition
|
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Term
| :runny nose, fever, sneezing, cough with "whoop" in children, low grade fever, cyanosis and apnea. |
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Definition
| Bordetella pertussis (Whooping cough) |
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Term
Mainly affects the lungs but may also infect the kidney, spine, and brain.
S&S = cough, CP, blood in sputum, weakness, decreased appetite, fever/chills and night sweats. |
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Definition
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Term
| What are the 2 ways to test for TB? |
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Definition
| Mantoux TB skin test and the special blood test to measure the immune response. |
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Term
| Can someone with latent TB still spread it? Will they have a positive skin test? Do they still need treatment? |
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Definition
| cannot spread, positive skin test, still needs treatment to prevent going to TB. |
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Term
| What corresponds to a positive PPD test for immunocompromised, recent immigrant/drug users/high risk populations, and persons with no known risk factors. |
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Definition
| 5mm or more for immunocompromised. 10mm or more for recent immigrant/drug users/high risk populations. 15mm or more for persons with no known risk factors. |
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Term
| What could cause a false positive PPD result? |
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Definition
| infection due to non-TB mycobacteria, BCG vaccine, user error. |
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Term
| What could cause a false negative PPD result? |
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Definition
| very recent TB infection, very old TB infection, user error |
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Term
| What is the principle treatment for TB? Others? |
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Definition
| INH - Isoniazid is principle. Others = rifampin, ethambutol and pyrazinamide. |
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Term
| :Serious disease that causes tightening of the muscles, death in 10%. |
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Definition
| Tetanus "lock jaw" - Clostridium tetani |
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Term
| Which tetanus vaccine is indicated for children younger than 7 and 10-64 if they have never received this vaccine? |
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Definition
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|
Term
| Which tetanus vaccine is indicated for patients 65 and over? |
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Definition
|
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Term
| :Strain of Staph aureus that has become resistant to beta-lactams and manifests as necrotizing fascitis and abscesses or endocarditis. |
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Definition
|
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Term
|
Definition
| sulfa drugs, clindamycin, tetracycline, vancomycin, maggots. |
|
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Term
| :Inflammation of the lymphatic channels, Caused by Streptococcus pyogenes or Staph, Erythematous streaking arising from a wound or insect bite, Associated lymph nodes are swollen and tender |
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Definition
| Lymphangitis "blood poisoning" |
|
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Term
| What are the 5 P's of STD history taking questions? |
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Definition
| partners, pregnancy prevention, protection from STDs, practices and past Hx of STDs. |
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Term
| Most common STD in the US? |
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Definition
|
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Term
| :STD characterized by ocular trachoma, lymphogranuloma venerum, epididymitis, cervicitis, conjunctivitis in newborns, and Reiter’s Syndrome aka (Reactive Arthritis) - Urethritis, conjunctivitis, and arthritis |
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Definition
|
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Term
| Screening tests for syphilis? |
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Definition
| RPR or VDRL with confirmatory FTA-ABS or TPPA. |
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Term
| Screening test for trichomoniasis? |
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Definition
| Microscopic exam on the vaginal fluid, culture and antigen detection test. |
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Term
| What is the screening test for genital herpes? |
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Definition
|
|
Term
| What is Gonorrhea commonly co-infected with? |
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Definition
| Chlamydia in 30-40% of cases |
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Term
|
Definition
| gram stain, culture and sensitivity, modified Thayer-Martin medium and chocolate agar. |
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Term
| Should pregnant women ever be treated with Quinolones or Tetracycline? Which antibiotic is safe to use in pregnant women? |
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Definition
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Term
| Which STD is termed "The Great Imitator"? |
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Definition
|
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Term
| Describe the primary, secondary and tertiary symptoms of Syphilis. |
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Definition
Primary = single painless chancre that heals on its own.
Secondary = widespread skin rash.
Tertiary = Internal organ damage, neurological defects, gummas. |
|
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Term
| :chancre sore that is painful. |
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Definition
|
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Term
| Causative agent for Chancroid? |
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Definition
|
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Term
| :Enlarged lymph nodes or ulcers in the inguinal/genital area, Rectal ulcers/bleeding |
|
Definition
| Lymphogranuloma Venereum (LGV) |
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Term
| Cause of Lymphogranuloma Venereum (LGV)? |
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Definition
| 3 strains of Chlamydia trachomatis |
|
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Term
| :1 or more blisters that develop into sores, crust over and heal without scarring. |
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Definition
|
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Term
| Can genital herpes be transmitted when sores are not present? |
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Definition
|
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Term
| :Frothy yellow-green vaginal discharge, Vaginal itching |
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Definition
|
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Term
| Which HIV strain is the more virulent and more infective strain? Less virulent and infective? |
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Definition
| HIV-1 (Global) is more. HIV-2 (W.Africa) is less. |
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Term
|
Definition
| ELISA with confirmatory Western blot. |
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Term
| What is the diagnostic criteria for AIDS? |
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Definition
| CD4 count below 200 cells/microL |
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Term
| What are some characteristic presenting symptoms of vitamin B12 deficiency? |
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Definition
| peripheral neuropathy (pins and needles sensation in hands and feet). |
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Term
| What kind of anemia has a characteristic burning of the tongue? |
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Definition
| Vitamin B12 and Folate deficiency anemia |
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Term
| Which anemia is commonly seen to have cravings for ice, starch or clay? |
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Definition
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Term
| Which anemia is seen with "chipmunk facies"? |
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Definition
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Term
| What anemia is seen with "frontal bossing" and "hand-foot" syndrome? |
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Definition
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Term
| Which anemia is seen most commonly with a patient with a smooth, beefy red tongue? |
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Definition
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Term
| If a guiac test on stool reveals occult blood, what anemia is indicated? |
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Definition
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Term
| Which anemia is most likely to have neurologic problems? |
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Definition
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|
Term
| Which leukemia is the most common in childhood? |
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Definition
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Term
| What is the most common leukemia in elderly men? |
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Definition
|
|
Term
| What kind of cells will be present on peripheral smear with CLL? |
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Definition
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|
Term
| What is indicative of AML on peripheral smear? |
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Definition
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|
Term
| Which leukemia is seen with a Philadelphia chromosome? |
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Definition
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|
Term
| How is CML differentiated from a leukemoid reaction? |
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Definition
|
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Term
| Common signs and symptoms of a lymphoma? |
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Definition
| Night sweats, pruritis, stridor, GI bleeding, back pain, hepatosplenomegaly, abdominal/head/neck/chest mass. |
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Term
| What condition is characterized by Reed Sternberg cells in lymph node tissue that is seen on a smear? |
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Definition
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|
Term
| Where is Haemophilis likely to infect? |
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Definition
|
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Term
|
Definition
| steroids to prevent airway compromise |
|
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Term
|
Definition
| Equine diptheria anti-toxin |
|
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Term
|
Definition
| antibiotics, metronidazole, tetanus immune globulin, muscle relaxers (Diazepam). |
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Term
|
Definition
|
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Term
|
Definition
|
|
Term
| What STDs are screened in all patients first visits? Women? |
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Definition
| All are screened for Syphilis and Hep A/B. Women are also screened for Chlamydia, Trichomoniasis (if fluid) and Gonorrhea. |
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Term
| What is the leading cause of preventable infertility and ectopic pregnancy in the US? |
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Definition
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Term
|
Definition
|
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Term
|
Definition
| Ceftriaxone, Cefixime, Ciprofloxacin and Doxycycline (for Chlamydia). |
|
|
Term
| What are some complications of Gonorrhea in women? |
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Definition
| Gland infection, PID and Fitz-Hugh-Curtis syndrome. |
|
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Term
|
Definition
|
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Term
|
Definition
| Ceftriaxone, Azithromycin, Erythromycin |
|
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Term
|
Definition
| Doxycycline (same as Chlamydia) |
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Term
|
Definition
|
|
Term
| Most common cause of vitamin B12 deficiency? |
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Definition
|
|
Term
| What ethnic groups is G6PD seen with commonly? |
|
Definition
| AA, Mediterranean, and Middle East |
|
|
Term
| What ethnic groups is Thalassemia seen with commonly? |
|
Definition
| Mediterranean and SE Asian |
|
|
Term
| What ethnic group is commonly seen with Hereditary Spherocytosis? |
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Definition
|
|
Term
| What anemia is most common with vegetarians? |
|
Definition
|
|
Term
| What anemias are seen with alcoholism? |
|
Definition
| Folate deficiency, iron deficiency, and sideroblastic (inability to incorporate iron to make heme) |
|
|
Term
| Most common occupational anemias? |
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Definition
| Aplastic (benzene or ionizing radiation) and Lead poisoning |
|
|
Term
| What kind of anemia results from chronic GI bleed? |
|
Definition
|
|
Term
| What kind of anemia has nail changes (brittle, flattening and spooning)? |
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Definition
|
|
Term
| What anemias are seen with cheilosis? |
|
Definition
| Iron deficiency and megaloblastic anemias |
|
|
Term
| Where would the soft systolic ejection murmur heard with severe anemia be heard best? |
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Definition
|
|
Term
| Which anemias are macrocytic? |
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Definition
| hemorrhagic, folate deficiency, B12 deficiency, hypothyroidism, alcoholism, liver disease. |
|
|
Term
| Which anemias are microcytic? |
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Definition
| Iron deficiency, Thalassemia, Lead poisoning |
|
|
Term
| Which anemias are normocytic? |
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Definition
| Aplastic, Anemia of chronic disease, Hemolysis, Renal failure, G6PD |
|
|
Term
| What are the only noticeable differences between Hemophilia A and B that I could find on the slides? |
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Definition
| A is more common and has prolonged PT and PTT, B just has a prolonged PTT. |
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Term
|
Definition
| pancytopenia with increased number of blasts |
|
|
Term
| CBC results for CLL? Differential seen on smear? |
|
Definition
| Anemia, thrombocytopenia, and lymphocytosis. Smudge cells on smear. |
|
|
Term
| CBC results for AML? Differential seen on smear? |
|
Definition
| Anemia and thrombocytopenia. Auer rods seen on smear. |
|
|
Term
| CBC results for CML? Differential seen on smear? |
|
Definition
| Anemia, thrombocytosis and leukocytosis. Philadelphia chromosome (I know its not on a smear but I didnt want the question to give it away). |
|
|
Term
| Malignancy of what cells leads to Non-Hodgkin's lymphoma? |
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Definition
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