Skin and others
Name the ABCDEF of skin lesions/moles
A: asymmetry
B: border irregularity
C: color variations
D: diameter greater than 6 mm
E: elevation or evolution
F: funny looking—“ugly duckling” —different from others
what do these manifestations describe
fatigue and cold intolerance, puffy edematous face especially around eyes (Periorbital edema) puffy hands and feet coarse facial hair cool, dry skin, dry coarse hair and eyebrows, slow reflexes ,sometimes thick speech
hypothyroidism/ Myxedema
what does this describe
Location: calf, lower leg
Character: aching, tiredness, feeling of fullness
Onset and duration: chronic pain, increases at end of day
Aggravating factors: prolonged standing, sitting
Relieving factors: Elevation, lying, walking
Associated symptoms: edema, varicosities, weeping ulcers at ankle
Those at risk: job with prolonged standing or sitting, obesity, multiple pregnancies, prolonged bed rest,
history of heart failure, varicosities, veins crushed by trauma or surgery
PVD (venous disease)
Manifestations include...
Whitish clouding, pt see’s yellow
lens opacity, resulting from a clumping of proteins in lens
curable with lens replacement surgery,
Cataract prevalence increases with age 40 years and older
leading cause of blindness worldwide
cataracts
This diseases causes patients not to be able tocannot wrinkle forehead, raise eyebrow, close eyelid, Whistle, show teeth on the left side, smooth forehead, wide palpebral fissure, flat nasolabial fold, Drooling, pain behind the ear
Bells palsey
what does this phrase describe?
Bubbling, gurgling or crackling noise
asthma,COPD, interstitial lung disease, bronchiectasis,heart failure, and pneumonia
Crackles
What do these manifestations describe?
Nervousness, fatigue, weight loss, muscle cramps, heat intolerance, forceful tachycardia, shortness of breath, excessive sweating, fine muscle tremor, thin silky hair, warm/ moist skin, infrequent blinking, staring appearance, brisk ankle jerks
hyperthyroidism/ Graves’ Disease
what do these manifestation describe?
Deep muscle pain in calf or foot
claudication (pain with walking, pain worsens with leg elevation, pain at rest indicates worsening of condition
Coolness in one foot or leg
pallor, elevational pallor,
dependent rubor
diminished pulses
systolic bruits,
signs Of malnutrition (thin, shiny skin; thick-ridged nails; atrophy of muscles)
distal gangrene
manifestations for arterial ulcers
a deviation in the parallel axes of the two eyes, light source does not hit both eyes (“cross eye”)
Amblyopia: “Lazy eye”
strabismus
What do these manifestations describe
Back pain, caused by a fractured or collapsed vertebra
Loss of height over time
A stooped posture
A bone that breaks much more easily than expected
kyphosis(hunch back)
Osteoporosis
What do these manifestations describe?
loss of cartilage between bones
Degenerative disease
asymmetrical
the more they move, the more they hurt(bone on bone)
no pain at rest
osteoarthritis is worse later in the day;
Osteoarthritis
What kind of headache includes bandlike tightness, viselike, no throbbing, no pulsatile, Gradual onset, lasts 30 minutes to days?
BONOUS (100 pts)
Where is this type of headache located?
Tension headache
Location: Usually both sides, across frontal, temporal, or occipital region of head.
Describe the Pulses associated with arterial insufficiency/disease (PAD)
weak , thready pulse- 1+
Hard to palpate
Need to search for it, may fade in and out, easily to obliterated by pressure
“Double vision”
perception of two images of a single object.
in one eye is caused by dry eyes, uncorrected refractive error, cataract.
Binocular diplopia, seen only when both eyes are open, occurs with misalignment of axes of eyes.
diplopia
What do these manifestations describe
chronic inflammation of synovial tissues, hyperplasia, and swelling lead to fibrosis, cartilage and bone destruction, which limit motion and show as deformity.
carries increased cardiovascular risk of heart attack and stroke.
pain is worse in the morning when arising
shows bilateral swelling and tenderness
Symmetrical
Rheumatoid arthritis
Ingrown Toenails causes (100 pts each)
trimming the nail too short
toe crowding in tight shoes
area becomes infected when the nail grows
corner penetrates the soft tissue.
What kind of headache includes throbbing, pulsating; moderate to severe pain. Aura (visual changes such as blind spots or flashes of light, tingling in an arm or leg, vertigo), Prodrome (change in mood, behavior, hunger, cravings, yawning), Nausea, vomiting, photophobia, phonophobia, abdominal pain, Person looks sick, Family history of migraine
BONOUS 100 pts Where is this headache located?
Migraine
Located commonly on one side, but may occur on both; pain behind the eyes, temple, or forehead
What do these manifestations describe?
Location: deep muscle pain, usually in calf, but may be lower leg or dorsum of foot
Character: intermittent claudication, feels like “cramp”, “numbness and tingling”, “feeling of cold”
Onset and duration: Chronic pain, onset gradual after exertion
Aggravating factors: activity (walking, stairs); “claudication distance” is a specific number of blocks or stairs
It takes to produce pain
Relieving factors: rest (usually within 2 minutes) dangling (severe involvement)
Manifestations of PAD (arterial disease)
redness is around the iris, in contrast with conjunctivitis, in which redness is more prominent at the periphery.
Pupil shape may be irregular from swelling of iris.
marked photophobia
constricted pupil
blurred vision throbbing pain.
PACG(Primary angle-closure glaucoma)
what are the 6 Preventions for Osteoporosis?
exercise(FAST WALKING IS THE BEST PREVENTATIVE MEASURE)
Diet
Increase calcium intake
Increase vitamin D
Limit smoking
Regular screening
name the 4 triggers for acute gout
Surgery
Trauma
Diuretics
alcohol intake
What kind of headache includes continuous, burning, piercing, excruciating; multiple times a day
Cluster
what is the number of blocks walked or stairs climbed to produce pain?
claudication distance
breakdown of cells in macula of retina; loss of central vision
Unable to do fine work
has difficulty distinguishing faces.
When the lifestyle is oriented around these activities, loss of central vision causes great distress.
Peripheral vision is not affected; for a while the person can manage self-care and not become completely disabled.
Macular Degeneration
Identify 4 ways to promote safety and Fall prevention
Build your strength with an exercise program
Review your medicines with your provider to check which ones hurt your balance
Check your vision and hearing every year—eyes and ears keep you on your feet.
Safety-proof your home: increase lighting, make stairs safe, remove trip hazards such as throw rugs, and install grab bars wherever needed.