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Dunphy Primary care IIB Test 3. Questions with 100% Correct Answers Latest 2024 Version
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Dunphy Primary care IIB Test 3. Questions with 100% Correct Answers Latest 2024 Version
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Dunphy Primary care IIB Test 3. Questions with 100%Correct Answers Latest 2024 Version
What is the psoas sign? - ✔✔Pain on passive extension of the right thigh. Patient lies on left
side. Examiner extends patient's right thigh while applying counter resistance to the right hip
What is the obturator sign? - ✔✔Pain on passive internal rotation of the flexed thigh. Examiner moves
lower leg laterally while applying resistance to the lateral side of the knee resulting in internal
rotation of the femur.
What is McBurney's point? - ✔✔+ rebound pain peritoneal inflammation, RLQ
If palpation of the left lower quadrant of a patient's abdomen increases the pain felt in the right lower
quadrant, the patient is said to have a positive ______ _____and may have an acute appendicitis. -
✔✔Rosving's sign
Diagnostics for Appendicitis? - ✔✔Laboratory findings are not diagnostic
Diagnosis is made from the history and physical exam (clinical diagnosis)
CBC usually reveals a mild to moderate leukocytosis (WBC 10 to 20,000 mcg/L) with a left shift
Urinalysis show microscopic hematuria or pyuria in 25% of patients
Urine human chorionic gonadotropin (hCG) test completed to rule out (ectopic) pregnancy
What might x-rays show of appendicitis? - ✔✔X-ray studies become more important as
appendicitis progresses
Plain x-ray films of the abdomen may show evidence of a fecalith, a gas-filled appendix, small bowel
ileus, a deviation in the bowel gas pattern, or a loss of the right iliopsoas shadow
what might a CT of the abdomen help with regarding Appendicitis? - ✔✔ruling out other
diagnostic possibilities
Abdominal ultrasound helps visualize the inflamed appendix and is also useful in ruling out other
potential diagnoses
,What might happen with a female patient related to appendicitis? - ✔✔Diagnostic laparoscopy may
be considered in female patients to rule out ectopic pregnancy, tubo-ovarian processes, or pelvic
inflammatory disease (PID)
What should be included in DDX for appendicitis? - ✔✔Urinary tract infection
Ectopic pregnancy
Ovarian cyst
Pneumonia
Gastroenteritis
Crohn's disease
Diverticulitis
Mesenteric adenitis
Pancreatitis
Pelvic inflammatory disease
Cholelithiasis
Appendicitis management- what antibiotics? - ✔✔Third-generation cephalosporins are the antibiotics
of choice
Ampicillin, gentamicin, clindamycin, metronidazole (Flagyl), ampicillin-sulbactam (Unasyn), and
ticarcillin/clavulanate (Timentin)
_______ should be avoided in appendicitis because they mask any developing symptoms that might
indicate a complication, such as perforation - ✔✔Narcotics
Constipation- definition - ✔✔change in bowel pattern
Decrease in frequency or increase in difficulty of defecation
Common in Western society
Most common GI disorder in the United States
Elderly
,Sedentary
Causes of constipation - ✔✔Lack of dietary fiber
Habitual use of laxatives
Irritable bowel syndrome (IBS)
Sedentary lifestyle
Change in environment or travel
Medications
Suppressing urge to defecate
Tumors
Hypothyroidism
Diabetes
Hypercalcemia
Pregnancy
Simple constipation causes - ✔✔Low fiber
Suppression of defecation
Disordered motility causes - ✔✔Slowed transit time
IBS
Diverticular disease
Secondary constipation causes - ✔✔Medications (e.g., codeine, morphine, calcium channel
blockers, aluminum antacids)
Chronic laxative use
Immobility
Chief complaints constipation - ✔✔Abd. pain (crampy)
Fecal description
, Bowel pattern (how frequently etc.)
PE- constipation - ✔✔Skin-hydration/turgor, color
Thyroid
Abdominal exam—inspection, auscultation, percussion, and palpation
Rectal exam
Stool for occult or frank blood
Epidermis consist of: - ✔✔Stratum corneum
Stratum germinativum
Stratum germinativum - ✔✔forms new skin cells
Forms permanent epidermal ridges on hands/feet by 17th week
Shape of ridges influenced by developing afferent nerve fibers
Distinctive patterns associated with some genetic syndromes
Melanocytes account for skin & hair tones by 7th week
Melanin in the skin reaches adult levels by 1 year of age protects DNA from damage by UV
light radiation
Which layer of epidermis is complete by 11 weeks in utero - ✔✔Stratum germinativum
What does the stratum germinativum do by week 17 - ✔✔Forms permanent epidermal ridges
on hands/feet
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