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, breast stage 5 mature stage- projection of nipple only; areola has receded to general contour of
the breast (although in some individuals the areola continues to form a secondary
mound)
Know where pain is located with pancreatitis: acute epigastric, may radiation straight to the back of other areas of the abdomen; 20%
with severe sequelae of organ failure
Know where pain is located with pancreatitis: chronic epigastric, radiating to back
Know how hepatitis A is transmitted Transmitted through fecal-oral route. Fecal shedding followed by poor
handwashing contaminates water and foods leading to infection of household
and sexual contacts
Stress incontinence the urethral sphincter is weakened so that transient increases in intra-abdominal
pressure raise the bladder pressure to levels that exceed urethral resistance.
Causes include childbirth and surgery, postmenopausal atrophy of the mucosa,
and urethral infection. May follow prostate surgery in men.
urge incontinence detrusor contractions are stronger than normal and overcome the normal urethral
resistance. The bladder is typically small. Mechanisms: Decreased cortical
inhibition of detrusor contractions from stroke, brain tumor, dementia, and lesions
of the spinal cord above sacral level. Also hyperexcitability of sensory pathways
ie: bladder infections, tumors, and fecal impaction. Deconditioning of voiding
reflexes ie: frequent voluntary voiding at low bladder volumes.
overflow incontinence detrusor contractions are insufficient to overcome urethral resistance, causing
urinary retention. The bladder is typically flaccid and large, even after an effort to
void. Mechanisms: obstruction of the bladder outlet ie: BPH or tumor. Weakness
of the detrusor muscle associated with peripheral nerve disease at S2-4 level.
Impaired bladder sensation that interrupts the reflex arc ie: diabetic neuropathy.
functional incontinence the patient is functionally able to reach the toilet in time because of impaired
health or environmental conditions. Mechanism: problems in mobility resulting
from weakness, arthritis, poor vision, or other conditions. Also environmental
factors such as an unfamiliar setting, distant bathroom facilities, bed rails, or
physical restraints.
Incontinence secondary to medications drugs may contribute to any type of incontinence listed. Ex: sedatives,
tranquilizers, anticholinergics, sympathetic blockers, and potent diuretics
Know where lymph nodes should be with strep · Strep throat àstreptococcal pharyngitis, bacterial infection that may cause a sore,
scratchy throat
· Common childhood infection has a classic presentation of erythema of the
posterior pharynx and palatal petechiae
· Enlarged swollen cervical lymph nodes -> superficial cervical lymph nodes
Superficial cervical -> superficial to the sternocleidomastoid
What vaccines are safe during pregnancy tdap, flu, Pneumococcal, meningococcal, Hepatitis B, rho gam
*NOT MMR, polio, or varicella