NBCE Part II - General Diagnosis Correct 100%

What does the acronym HIPPIRONEL stand for? - Answer History Inspection Palpation Percussion Instrumentation Ranges of Motion Orthopedics Neurological (E)x-ray Laboratory Your notes on the present illness should include what information? - Answer Location Mechanism Neurological Onset Pallative/Provocative factors Quality of pain Radiation/Referral Severity/Site/Setting Timing What should be included in a patient's past history? - Answer Immunizations Past illnesses Hospitalizations/operations Injuries Allergies How does pain of vascular origin present? - Answer Throbbing What is the normal range for body temperature (oral)? How much higher or lower should a rectal temperature be? What about axillary? - Answer 96-99.5 degrees F (35-37.5 degrees C) Rectal: 0.4-0.5 degrees C higher than oral Axillary: 1 degree F less than oral What are Korotkof sounds? - Answer Sounds heard with a stethoscope while taking blood pressure What is a normal respiratory rate for an adult? Infants? - Answer Adult: 12-20 per minute Newborn: 44 per minute What is a normal pulse rate for an adult? Children? Newborn? Elderly? - Answer Adult: 60-100 bpm (72 for men, 80 for women) Children: 90-140 bpm Newborn: 120-160 bpm Elderly: 70-80 bpm What is a normal blood pressure for an adult? Children? - Answer Adult: 90/60 mmHg - 140/90 mmHg Children: 90/60 mmHg - 100/70 mmHg What is pulse pressure? - Answer The difference between systole and diastole Normally 30-40 mmHg What is Maigne's Test? - Answer Vertebro-basilar artery functional maneuver bilaterally Patient actively turns and hyperextends head as far left as possible up to 30 seconds; repeat on right side Note ischemic reactions such as vertigo, nausea, blurriness, fainting, nystagmus What are risk factors of CVA? - Answer Arteriosclerosis Hypertension Cervical spine spondylosis Birth control pills Smoking Past CVA How would you assess the Subclavian a.? What are positive findings for these tests? - Answer Take blood pressure in both arms (10 mmHg difference between systolic pressures) Auscultate supraclavicular fossa (bruit) Curshmann's spirals and Charcot laden crystals are associated with what pathology? - Answer Asthma Which enzymes will rise in a patient with a MI? - Answer 1. CPK 2. SGOT 3. LDH What enzymes will rise in a patient with pancreatitis or pancreatic cancer? - Answer Amylase and lipase Which enzymes are associated with renal disease? - Answer BUN Uric acid Creatinine Which enzymes are associated with liver disease? - Answer SGPT BUN Bilirubin Alkaline phosphatase What is choriocarcinoma? - Answer Placenta cancer What are the lab findings of Multiple Myeloma? - Answer M spike on protein electrophoresis Bence Jones proteinuria Increased ESR Normochromic, normocystic anemia Rouleaux formation Exophthalmosis is associated with what disease? - Answer Grave's disease What is ectropion? Entropion? - Answer Lid turned outward Lid turned inward Both found in elderly Blue sclera is indicative of what disease? - Answer Osteogenesis imperfecta What is seborrhea? - Answer Dandruff Horner's syndrome includes what three things? - Answer Ptosis Anhydrosis Myosis What is your DDx. for an ivory vertebrae? - Answer Hodgkins Lymphoma (scalloping on anterior aspect) Blastic mets Pagets disease (cortical thickening) Idiopathic What is a hordeolum? - Answer Pimple or boil on eyelid margin (sty) Indicates infection of sebaceous glands What is a chalazion? - Answer Nodule which points inside the lid Indicates infection of meibomian gland What is a pinguecula? - Answer Yellowish triangular nodule in the bulbar conjunctiva (Cause of aging) Fatty plaques on the nasal surface of eyelids are known as what? - Answer Xanthelasmas Argyll Robertson pupil is associated with what disease? - Answer Syphilis How does a patient with Argyll Robertson pupil present? - Answer Pupil accommodates but does not react to light Small, irregular, bilateral Internal Ophthalmoplegia is associated with what disease? How do it appear? - Answer Multiple Sclerosis Dilated pupil with ptosis and lateral deviation Does not react to light or accommodate What is miosis? - Answer Pinpoint pupils