This site is 100% ad supported. Please add an exception to adblock for this site.

FCM M1 Final Exam Review

Terms

undefined, object
copy deck
what is the most important clinical tool that physicians use for the diagnosis and treatment of patients?
the medical interview
what are the three basic functions of the medical interview?
(1) data gathering

(2) building rapport and responding to emotions

(3) patient education and negotiation of treatment plans
what are the eight components of the comprehensive adult medical history?
(1) identifying data

(2) source and reliability of history

(3) chief complaint

(4) HPI

(5) PMH

(6) FH

(7) SH

(8) Review of Systems
what are the two components one would add to a normal comprehensibe adult medical history to make a comprehensive geriatric medical history?
(1) functional assessment

(2) mental status exam (in the physical exam)
what are the two components one would add to a normal comprehensibe adult medical history to make a comprehensive pediatric medical history?
(1) developmental history

(2) nutrition history
what are the three fxns of the physical exam?
(1) to ascertain the cause(s) of illness and to follow the progression of disease

(2) to screen for asymptomatic disease(s)

(3) to reassure the patient and to support a therapeutic patient-physician relationship
what side of the exam table does the examiner usually stand on?
the right side
what is a smart way to modify the order of the physical exam for young children?
least distressing aspects of the exam are done first
what is the HPI mnemonic?
LQQTSMA
differentiate between disease / illness
disease: what is causing the patient's symptoms

illness: how the patient experiences the symptoms
body mass index
calculated by weight (kg) / height squared (m2)
when might BMI be falsely elevated or falsely normal?
falsely elevated in a muscular but lean person

falsely normal in an elderly and wasted person
waist circumference, what measurements suggest excess body fat?
>35 inches in women

>40 inches in men
what are the three layers of the skin?
(1) epidermis: thin, avascular layer

(2) dermis: vascular

(3) subcutaneous tissue: fat
vellus (hair)
short, fine unpigmented hair
terminal hair
head, underarm, pubic regions
macule
small flat spot, up to 1.0 cm

e.g. freckle, petechia
patch
big flat spot, greater than 1.0 cm
papule
small solid bump, up to 1.0 cm
plaque
big solid bump, greater than 1.0 cm, often made up of papules that run together
nodule
deep, round, hard bump greater than 0.5 cm
wheal
an irregularly shaped raised area
vesicle
fluid filled bump, up to 1.0 cm, filled with serous fluid
bulla
big fluid filled bump, 1.0 cm or larger, filled with serous fluid
pustule
filled with pus
erosion
loss of the superficial skin that does not bleed
ulcer
deeper loss of skin that may bleed and scar
fissure
a linear crack in the skin
crust
dried pus, blood, serum on the skin
scale
flakes of skin
lichenification
when skin becomes rough and thick
atrophy
thinning of the skin with loss of furrows; the skin looks more transparent and shiny
excoriation
scratch mark
scar
thick and pink (hypertrophic) vs. thin and white (atrophic)
comedo
blackhead
what are the four components used for most medical records?
(1) medical history

(2) physical examination

(3) assessment

(4) plan
rectal temp is different value than oral temp?
rectal temp is about 0.5 degree C above oral temp
axillary temp is different value than oral temp?
axillary temp is about one degree below oral temp (least accurate)
tympanic membrane is different value than oral temp?
tympanic membrane is about 0.8 degrees C above oral temp
blood pressure cuff size
choose cuff size so bladder nearly (80%) or completely encircles arm
deflating the BP cuff too fast can result in what?
underestimating the systolic P and overestimating the diastolic P
if excessive pressure is hold on the stethoscope head a falsely ______ diastolic reading may be seen
low
normal BP
<120/<80
prehypertension
120-139/80-89
Stage 1 Hypertension
140-159/90-99
Stage 2 Hypertension
>=160/>=100
width of the inflatable BP bladder should be what % of upper arm circumference?
40%
name 5 factors associated with increased risk for breast cancer
(1) onset menstruation before 13 years

(2) menopause after 55 years

(3) prior history of breast cancer

(4) first-degree family history of breast cancer

(5) history of never being pregnant
CAGE
have you ever felt the need to cut down on your drinking?

Have you ever felt annoyed by the criticism of your drinking?

Have you ever felt guilty about drinking?

Have you ever needed a drink first thing in the morning (eye-opener)?
hypertension
- general definition
at least two elevated BP measurements at two or more visits
a femoral pulse that is smaller and later than the radial pulse is suggestive of what?
coarctation of the aorta or occlusive vascular disease
pelse rates
Birth:
1-2 years:
6-10 years:
10-14 years:
Birth: 140
1-2 years: 110
6-10 years: 95
10-14 years: 85
RR
Newborn:
Early Childhood:
Late Childhood:
Newborn: 30-60
Early Childhood: 20-40
Late Childhood: 15-25
what are the four parts of the denver developmental screening test?
(1) personal-social

(2) fine motor-adaptive

(3) language

(4) gross motor
HEADSS
Home
Education
Activities
Sex
Suicide
SIG E CAPS
Sleep decreased (Insomnia with 2-4 am awakening)
Interest decreased in activities (anhedonia)
Guilt or worthlessness (Not a major criteria)
Energy decreased
Concentration difficulties
Appetite disturbance or weight loss
Psychomotor retardation/agitation
Suicidal thoughts
where is the costovertebral angle?
formed by the lower border of the 12th rib and the transverse processes of the upper lumbar vertebrae
tenderness in the area of the costovertebral angle may signify what?
kidney problem
when does the posterior fontanelle close?
2 months
when does the anterior fontanelle close?
by two years of age
what are the names used in the three quadrant system for abdomen?
epigastric (upper)

umbilical

hypogastric (lower)
odynophagia
pain on swallowing
obstipation
no passage of either feces or gas
what is the normal liver span at the right midclavicular line?
6-12 cm
on inspiration, the liver is palpable ___ cm below the right costal margin in the midclavicular line?
3 cm
boundaries of the anterior triangle of the neck
bounded above by the mandible, laterally by the sternocleidomastoid, and medially by the midline of the neck
boundaries of the posterior triangle of the neck
extends from the sternocleidomastoid to the trapezius and is bounded below by the clavicle
palpebral conjunctiva lines what?
the eyelids
bulbar conjunctiva covers what?
the eyeball
what are the three glands of the eye that produce tears?
meibomian, conjunctival, and lacrimal
lacrimal puncta
the "drains" of the eyes that drain tears
ciliary body fxn
adjusts the thickness of the lens
describe the flow of aqueous humor
flows from the "posterior chamber" to the "anterior chamber" then drains out through canal of schlemm
glaucoma
inc eye pressure
optic disc
orangish to pinkish oval structure, 1.5 mm in diameter
near reaction
involves convergence and accommodation
presbyopia
gradual dec in near vision caused by stiffening of the lens
large pupil
>5 mm
small pupil
<3 mm
synovial joint
freely moveable

e.g. knee, shoulder
catilaginous joint
lightly moveable

e.g. vertebral bodies of the spine
fibrous joint
immovable

e.g. skull sutures
shoulder:
where does the supraspinatous insert?
greater tubercle
shoulder
insfraspinatous and teres minor
cross the glenohumoral joint posteriorly, insert on the greater tubercle
shoulder:
where does the subscapularis insert?
on the lesser tubercle
axioscapular group
attaches the trunk to the scapula and includes the trapezius, rhomboids, serratus anterior, and levator scapulae; rotate the scapula
axiohumeral group
this group attaches the trunk to the humerus and includes the pectoralis major and minor and the latissimus dorsi; these muscles produce internal rotation of the shoulder
biceps tendon
tendon of the long head of the biceps; runs in the bicipital groove between the greater and lesser tubercles
primary hip flexor
iliopsoas
primary hip extensor
gluteus maximus
kyphosis
hunchback
valgus stress test -- inward or outward?
inward
varus stress test -- inward or outward?
outward
pectoral nodes drain what?
anterior of the chest
subscapular nodes drain what?
posterior chest wall and portions of the arm
lateral nodes drain what?
most of the arm
where do the pectoral / subscapular / lateral nodes drain into?
drain to central axillary nodes --> to infraclavicular and supraclavicular nodes
when is the best time to perform a breast exam?
5-7 days after menstruation
where does the trachea bifurcate?
at the level of the sternal angle anteriorly and at the T4 spinous process posteriorly
dyspnea
awareness of breathing that is inappropriate to the level of breathing
hemoptysis
coughing up blood from the lungs
Hoover's sign
infant's abdomen bulges outward while the chest moves inward during inspiration
where does the lower border of the lung cross at midclavicular and midaxillary lines?
6th rib midclavicular

8th rib midaxillary
posterior lower border of lung?
at level of T10 spinous process
where is the PMI?
found in the 5th interspace 7-9 cm lateral to the midsternal line
axvy
atrial contraction, relaxation, filling, emptying

Deck Info

106

permalink