health hx includes: CORRECT ANSWERS: CC, past health hx, personal and social hx, ROS
CC Hx CORRECT ANSWERS: the reason the pt is seeking care and should be obtained in the pt's own words
OPQRST CORRECT ANSWERS: Sudden onset: thinking vascular stroke, MI, musculoskeletal
Q: Throbbing=vascu...
NBCE Parts 2 & 3 - General Diagnosis
QUESTIONS AND ANSWERS
health hx includes: CORRECT ANSWERS: CC, past health hx, personal and social hx, ROS
CC Hx CORRECT ANSWERS: the reason the pt is seeking care and should be obtained in the
pt's own words
OPQRST CORRECT ANSWERS: Sudden onset: thinking vascular stroke, MI, musculoskeletal
Q: Throbbing=vascular. Ache=Muscular. Burning=nerve. Tearing=dissecting aneurysm.
Radiating below the knee=nerve root. NOT below the knee=facet syndrome
Timing: Headache in the morning=hypertension. Constant=Malignancy
CAGE Questionnaire: referring to alcoholism CORRECT ANSWERS: C=cutting down (have
you felt the need to cut down?)
A=Annoyed by others criticisms
G=guilty feelings about drinking
E=Eye openers-do you feel the need to drink in the morning?
Normal temps:
Oral, Rectal/tympanic, axilla, range CORRECT ANSWERS: oral=98.6
rectal-tympanic=99.6
axilla=97.6
range=96-99.5 or 35-37.5 Celsius
BP
Normal, hypertension, hypotension CORRECT ANSWERS: 120/80
140/90
90/60
Barre-Lieou CORRECT ANSWERS: pt seated, examiner instructs the pt to rotate the head
maximally from side to side. Done slowly at first than accelerated to pt tolerance
DeKleyn's CORRECT ANSWERS: Pt supine, the examiner instructs the pt to rotate and extend
the head off the table then turn to each side for 15-45 secs. doc can lend minimal support
,Hallpike CORRECT ANSWERS: an enhanced DeKlyn's. pt supine, head extended off table.
examiner support for the skull. examiner brings head in extension rotation and lateral flexion
hautant's CORRECT ANSWERS: pt seated, arms extended forward to shoulder level with the
hands supinated. Maintain position for a few secs. Pt then closes the eyes, rotates and
hyperextends the neck to one side. Repeated to opposite side
Underberg CORRECT ANSWERS: Pt stands with eyes open arms at side feet close together. Pt
closes eyes, extends arms and supinates hands then pt extend and rotates head to one side. Then
in position pt is instructed to march in place
Eyebrows: CORRECT ANSWERS: Scaly = seborrhea
Loss of lateral 1/3 = myxedema
quantitative loss is normal with age
Ptosis CORRECT ANSWERS: drooping of the eyelid seen with Myesthenia Gravis and
Horner's as we lose the sympathetic. Also Meiosis (constricted pupil) and anhydrosis are seen
with Horner's.
CN 3 paralysis will dilate the pupil
Horner's: CORRECT ANSWERS: Ptosis, Meiosis, Anhydrosis on the same side as the
interruption in the cervical sympathetics. PANCOAST TUMOR
exopthalmosis CORRECT ANSWERS: lid lag/failure to cover the eyeball seen with graves
(bilateral) or tumor (unilateral)
Ectropion CORRECT ANSWERS: Lid is turned outward and seen in the elderly
Entropion CORRECT ANSWERS: Lid is turned inward and seen in the elderly
Periorbital edema CORRECT ANSWERS: swelling around the eyes seen with allergies, MX,
and nephrotic syndrome
Blepharitis CORRECT ANSWERS: inflammation of the eyes seen with Seborrhea, staph
infection, and inflammatory process
Cataracs CORRECT ANSWERS: opacities seen in the lens that are commonly seen with
diabetes and in the elderly. also has absent red light reflex
Corneal Arcus CORRECT ANSWERS: AKA Arcus Senalis:
grayish opaque ring around cornea. early <50yo (hypercholesterlemia)
Elderly >50yo NORMAL
Pterygium CORRECT ANSWERS: triangular thickening of the bulbar conjunctiva that grows
across the cornea and is brought on by dry eyes
Hordoleum (sty) CORRECT ANSWERS: an infrction of the sebaceous gland causing a pimple
or boil on the eyelid
chalazion CORRECT ANSWERS: an infection of the meibomian bland causing a nodule that
points inside the eyelid
Pinquecula CORRECT ANSWERS: a yellowish triangular nodule in the bulbar conjunctiva that
is harmless and indicates aging
Xanthelasma CORRECT ANSWERS: fatty plaques on the nasal surface of the eyelids that is
normal or indicates hypercholesterolemia
Argyll Robertson CORRECT ANSWERS: bilateral small and irregular pupils that accommodate
but do not react to light. seen with SYPHILIS = PROSTITUTES PUPIL
internal opthalmoplegia CORRECT ANSWERS: dilated pupil with ptosis and lateral deviation.
Doesn't react to light or accommodation. MULTIPLE SCLEROSIS
Mydriasis CORRECT ANSWERS: dilated and fixed pupils seen with anticholinergic drugs
(atropine/mushrooms/death)
Miosis CORRECT ANSWERS: fixed and dilated pupils that react to light and accommodate.
Seen with devere brain damage, pilocarpine medications and narcotic use
Anisocoria CORRECT ANSWERS: unequal pupil size
Adie's pupil CORRECT ANSWERS: sluggish pupillary reaction to light that is unilateral and
caused by a parasympathetic lesion of CN 3
Arroyo sign CORRECT ANSWERS: sluggish puppilary reaction due to hyperadrenalism
(addison's dx)
Glaucoma CORRECT ANSWERS: increased introcular pressure causing cupping of the optic
disc (cup to disc ratio >1:2
Pt will notice blurring of vision especially in the peripheral as well as rings around lights.
Crescent sign with tangential lighting of cornea
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