Lecture 1
What is the red flag constitutional symptom?
sudden, unintentional, weight change
5% or more over six months
what is the difference between weakness and fatigue?
fatigue is nondescript weariness or loss of energy
weakness is a demonstrable loss of power
A 28-year-old female presents with multiple round, coin-shaped eczematous plaques on her arms and legs with overlying transudative crust. She reports that they are very itchy. Which term best describes these coin-shaped lesions?
nummular
This type of medical note is written when a patient is moved from one unit to another within the same hospital—such as moving from the Intensive Care Unit to a medical-surgical floor—to ensure seamless continuity of care.
Transfer-of-care (handoff note)
Unlike nociceptive pain, this type of pain is a direct consequence of a lesion or disease affecting the somatosensory system and is often described as electric shock-like, burning, or stabbing
neuropathic pain
What does the acronym IPPA stand for?
Inspection, Palpation, Percussion, Auscultation
A patient with a BMI of 30.8 is classified how?
Obesity Class 1
A 58-year-old male with chronic kidney disease presents with a skin lesion on his nose. Physical examination shows yellowish, globular papules with a central depression, and inspection under magnification reveals telangiectasias that go around, rather than over, the lesion. Which of the following is the most likely diagnosis?
Sebaceous hyperplasia
Occupational status, substance use, living environment, safety measures, and baseline functional status (ADLs/IADLs) belong under this specific section of a comprehensive H&P.
social history
If a patient states that an itch comes before the rash which skin condition is the most likely culprit?
eczema - atopic dermatitis
According to JNC 8 criteria, an adult with a systolic blood pressure between 130 and 139 mm Hg or a diastolic pressure between 80 and 89 mm Hg falls into this classification
Stage 1 hypertension
device for accurate measurement of height
stadiometer
Associated with vasodilation and potential chronic hypoxia, this condition features soft tissue bulbous swelling at the nail base with an angle greater than 180 degrees.
Digital clubbing
What is the key difference between a comprehensive H&P and a directed H&P
A comprehensive H&P includes all components of history and a directed H&P is problem-focused and tailored to a specific component.
What is an auscultatory gap? Causes?
interval or pressure where Korotkoff sounds indicating the systolic fade away and reappear at lower pressure
- arterial stiffness and arteriosclerosis
What does the NURSE acronym stand for?
Name
Understand/legitimize
Support
Explore
What level of consciousness is this patient response?
Opens eyes and looks at examiner, responds slowly and confused; alertness and interest decreased
obtunded
What triad of diseases often occur together in dermatology? (hint: when we discussed pruritis)
seasonal allergies, asthma and eczema
Why are opposing binary terms used in medical documentation?
to describe findings clearly and aid in comparison
What are Kussmaul respirations?
fast and shallow converting to slow, deep and gasping
ex. DKA
A drop of at least 20 mm Hg in systolic blood pressure or at least this many mm Hg in diastolic blood pressure within 3 minutes of standing confirms orthostatic hypotension.
10 mmhg
Calculated by subtracting the diastolic pressure from the systolic pressure, this value represents the physical force the heart generates when it contracts.
pulse pressure
Answer: Characterized by a ground-glass appearance of the nail plate, reddish-brown distal bands, and complete obliteration of the lunula across virtually every nail, this finding is classically associated with severe systemic conditions such as liver disease, heart failure, and diabetes.
Terry nails <3
ONLY during an ---- ---- ------------ is it appropriate to state 'unremarkable' during the physical exam and 'within normal limits for remaining diagnostics
oral case presentation
Characterized by periods of deep breathing alternating with periods of apnea, this abnormal respiratory pattern is commonly observed in critically ill patients.
Cheyne-Stokes respirations