NR 509 midterm
Cause of saddle numbness and urinary retention - ANS Cauda equina syndrome
Presentation of retinal detachment - ANS If sudden visual loss is unilateral and painless,
Obtunded - ANS patient opens the eyes and looks at you but responds slowly and is somewhat
confused. Alertness and interest in the environment are decreased.
Cranial nerve for lateral gaze - ANS CN6: Abducens
Adult Illnesses - ANS Medical: Illnesses such as diabetes, hypertension, hepatitis, asthma, and
human immunodeficiency virus (HIV); hospitalizations; number and gender of sexual partners;
and risk-taking sexual practices
■ Surgical: Dates, indications, and types of operations
■ Obstetric/Gynecologic: Obstetric history, menstrual history, methods of contraception, and
sexual function
■ Psychiatric: Illness and time frame, diagnoses, hospitalizations, and treatments
Present Illness - ANS chronologic description of the problems prompting the patient's visit,
including the onset of the problem, the setting in which it developed, its manifestations, and any
treatments to date.Each problem/symptom needs: (1) location; (2) quality; (3) quantity or
severity; (4) timing, including onset, duration, and frequency; (5) the setting in which it occurs;
(6) factors that have aggravated
-meds, allergies, tobacco use, ETOH and drug use
Absence of red reflex - ANS an opacity of the lens (cataract) or, possibly, the vitreous (or even
an artificial eye). Less commonly, a detached retina or, in children, a retinoblastoma may
obscure this reflex.
S/S of seasonal allergies - ANS Itching, watery eyes, sneezing, ear congestion, postnasal
drainage
Presentation of optic neuritis - ANS Enlarged blind spot, vision loss in 1 eye, loss of color
vision, hole in center of vision, trouble seeing to the side, eye pain
pityriasis rosea - ANS Multiple round to oval scaling violaceous plaques on abdomen and back
Acromion - ANS tip of shoulder
, What to do for + finding on physical exam, but - workup - ANS continue using test, but less lab
and diagnostics
Cause of falsely high BP - ANS -too small of a BP cuff
- if the brachial artery is below heart level
- loose cuff
- bladder that balloons outside the cuff
Check for nystagmus - ANS -involuntary jerking movement of the eyes with quick and slow
components.
- It is named for the direction of the quick component
- seen in cerebellar disease and vestibular disorders and in internuclear ophthalmoplegia
Jaundice - ANS yellow sclera
how do get a patient to open up when upset - ANS effective reassurance is simply identifying
and acknowledging the patient's feelings.
-Partnering
-Summarizing
-Transitions
- Empowering the pt
s/s of degenerative pain - ANS -Slowly progressive, with temporary exacerbations after periods
of overuse
-usually insidious
- flexion and deviation deformities
How otosclerosis presents with Weber and Rinne test - ANS - Weber: Sound lateralizes to
impaired ear. Room noise not well heard, so detection of vibrations improves
- Rinne: BC longer than or equal to AC. While air conduction through the external or middle ear
is impaired, vibrations through bone bypass the problem to reach the cochlea.
Cherry angiomas - ANS Benign
Interpreting visual acuity test - ANS Vision of 20/200 means that at 20 feet the patient can read
print that a person with normal vision could read at 200 feet. The larger the second number, the
worse the vision. "20/40 corrected" means the patient could read the 20/40 line with glasses (a
correction).
Sequence of the interview - ANS Preparation. Then, Greeting the patient and establishing
rapport. Establishing the agenda for the interview. Inviting the patient's story. Exploring the
patient's perspective. Identifying and responding to emotional cues. Expand-ing and clarifying
the patient's story. Generating and testing diagnostic hypotheses. Sharing the treatment plan.
Closing the interview and the visit. Taking time for self-reflection.
Cause of saddle numbness and urinary retention - ANS Cauda equina syndrome
Presentation of retinal detachment - ANS If sudden visual loss is unilateral and painless,
Obtunded - ANS patient opens the eyes and looks at you but responds slowly and is somewhat
confused. Alertness and interest in the environment are decreased.
Cranial nerve for lateral gaze - ANS CN6: Abducens
Adult Illnesses - ANS Medical: Illnesses such as diabetes, hypertension, hepatitis, asthma, and
human immunodeficiency virus (HIV); hospitalizations; number and gender of sexual partners;
and risk-taking sexual practices
■ Surgical: Dates, indications, and types of operations
■ Obstetric/Gynecologic: Obstetric history, menstrual history, methods of contraception, and
sexual function
■ Psychiatric: Illness and time frame, diagnoses, hospitalizations, and treatments
Present Illness - ANS chronologic description of the problems prompting the patient's visit,
including the onset of the problem, the setting in which it developed, its manifestations, and any
treatments to date.Each problem/symptom needs: (1) location; (2) quality; (3) quantity or
severity; (4) timing, including onset, duration, and frequency; (5) the setting in which it occurs;
(6) factors that have aggravated
-meds, allergies, tobacco use, ETOH and drug use
Absence of red reflex - ANS an opacity of the lens (cataract) or, possibly, the vitreous (or even
an artificial eye). Less commonly, a detached retina or, in children, a retinoblastoma may
obscure this reflex.
S/S of seasonal allergies - ANS Itching, watery eyes, sneezing, ear congestion, postnasal
drainage
Presentation of optic neuritis - ANS Enlarged blind spot, vision loss in 1 eye, loss of color
vision, hole in center of vision, trouble seeing to the side, eye pain
pityriasis rosea - ANS Multiple round to oval scaling violaceous plaques on abdomen and back
Acromion - ANS tip of shoulder
, What to do for + finding on physical exam, but - workup - ANS continue using test, but less lab
and diagnostics
Cause of falsely high BP - ANS -too small of a BP cuff
- if the brachial artery is below heart level
- loose cuff
- bladder that balloons outside the cuff
Check for nystagmus - ANS -involuntary jerking movement of the eyes with quick and slow
components.
- It is named for the direction of the quick component
- seen in cerebellar disease and vestibular disorders and in internuclear ophthalmoplegia
Jaundice - ANS yellow sclera
how do get a patient to open up when upset - ANS effective reassurance is simply identifying
and acknowledging the patient's feelings.
-Partnering
-Summarizing
-Transitions
- Empowering the pt
s/s of degenerative pain - ANS -Slowly progressive, with temporary exacerbations after periods
of overuse
-usually insidious
- flexion and deviation deformities
How otosclerosis presents with Weber and Rinne test - ANS - Weber: Sound lateralizes to
impaired ear. Room noise not well heard, so detection of vibrations improves
- Rinne: BC longer than or equal to AC. While air conduction through the external or middle ear
is impaired, vibrations through bone bypass the problem to reach the cochlea.
Cherry angiomas - ANS Benign
Interpreting visual acuity test - ANS Vision of 20/200 means that at 20 feet the patient can read
print that a person with normal vision could read at 200 feet. The larger the second number, the
worse the vision. "20/40 corrected" means the patient could read the 20/40 line with glasses (a
correction).
Sequence of the interview - ANS Preparation. Then, Greeting the patient and establishing
rapport. Establishing the agenda for the interview. Inviting the patient's story. Exploring the
patient's perspective. Identifying and responding to emotional cues. Expand-ing and clarifying
the patient's story. Generating and testing diagnostic hypotheses. Sharing the treatment plan.
Closing the interview and the visit. Taking time for self-reflection.
