Podcast
Questions and Answers
Which of the following conditions is characterized by the absence of periods after they have been established?
Which of the following conditions is characterized by the absence of periods after they have been established?
- Polymenorrhea
- Secondary amenorrhea (correct)
- Primary amenorrhea
- Oligomenorrhea
Which of the following best describes primary dysmenorrhea?
Which of the following best describes primary dysmenorrhea?
- Related to pelvic inflammatory disease (PID).
- Results from increased prostaglandin production during the luteal phase. (correct)
- Caused by endometriosis in the muscular layers of the uterus.
- Associated with structural abnormalities such as endometrial polyps.
Which of the following conditions is defined by menstrual bleeding between expected periods?
Which of the following conditions is defined by menstrual bleeding between expected periods?
- Menorrhagia
- Oligomenorrhea
- Polymenorrhea
- Metrorrhagia (correct)
A patient reports experiencing pelvic pain, dyspareunia, and dysmenorrhea. Which of the following categories does this collection of symptoms fall under?
A patient reports experiencing pelvic pain, dyspareunia, and dysmenorrhea. Which of the following categories does this collection of symptoms fall under?
A patient presents with dysuria, frequency, and urinary incontinence. Within a gynecological history, which area does this symptom cluster primarily relate to?
A patient presents with dysuria, frequency, and urinary incontinence. Within a gynecological history, which area does this symptom cluster primarily relate to?
A patient reports experiencing emotional, behavioral, and physical symptoms that consistently appear 6 days before the onset of menses. According to the criteria for premenstrual syndrome (PMS), what is the most appropriate next step in evaluating this patient?
A patient reports experiencing emotional, behavioral, and physical symptoms that consistently appear 6 days before the onset of menses. According to the criteria for premenstrual syndrome (PMS), what is the most appropriate next step in evaluating this patient?
A 52-year-old patient reports absence of menses for 10 consecutive months. She denies experiencing hot flashes or any other unusual symptoms. Which of the following is the most appropriate next step?
A 52-year-old patient reports absence of menses for 10 consecutive months. She denies experiencing hot flashes or any other unusual symptoms. Which of the following is the most appropriate next step?
A patient reports regular menses occurring every 19 days. How would you document this in her chart?
A patient reports regular menses occurring every 19 days. How would you document this in her chart?
A 28-year-old patient, who is not currently pregnant, reports intermittent spotting between her regular menstrual periods. How should this be documented?
A 28-year-old patient, who is not currently pregnant, reports intermittent spotting between her regular menstrual periods. How should this be documented?
Fill in the blank: ___________ is defined as the number of times a woman has given birth to a baby of viable age (≥24 weeks) regardless of birth outcome.
Fill in the blank: ___________ is defined as the number of times a woman has given birth to a baby of viable age (≥24 weeks) regardless of birth outcome.
During a speculum exam, if the cervix isn't immediately visible, what is the MOST appropriate next step?
During a speculum exam, if the cervix isn't immediately visible, what is the MOST appropriate next step?
What is the correct angle of insertion of the speculum into the vagina during an internal exam?
What is the correct angle of insertion of the speculum into the vagina during an internal exam?
What should a practitioner do immediately after visualizing the cervix during a speculum exam?
What should a practitioner do immediately after visualizing the cervix during a speculum exam?
When performing a bimanual exam, what specific characteristic of the cervix are you assessing?
When performing a bimanual exam, what specific characteristic of the cervix are you assessing?
During a bimanual exam, what hand placement technique is used to palpate the uterus effectively?
During a bimanual exam, what hand placement technique is used to palpate the uterus effectively?
In what order should you obtain a Pap smear and cervical cultures? What is the rationale for this sequence?
In what order should you obtain a Pap smear and cervical cultures? What is the rationale for this sequence?
What specific actions should be taken while withdrawing the speculum to maximize the informational yield of the examination?
What specific actions should be taken while withdrawing the speculum to maximize the informational yield of the examination?
During a female pelvic examination, what is the MOST critical instruction regarding the patient's positioning to ensure proper access and comfort?
During a female pelvic examination, what is the MOST critical instruction regarding the patient's positioning to ensure proper access and comfort?
Which of the following phrases is MOST appropriate to use when initiating the physical examination portion of a pelvic exam, to empower the patient?
Which of the following phrases is MOST appropriate to use when initiating the physical examination portion of a pelvic exam, to empower the patient?
When conducting the external examination of the female genitalia, which specific area requires inspection for pubic hair pattern and distribution?
When conducting the external examination of the female genitalia, which specific area requires inspection for pubic hair pattern and distribution?
During the inspection of the labia majora, which specific characteristics should be evaluated to identify potential abnormalities?
During the inspection of the labia majora, which specific characteristics should be evaluated to identify potential abnormalities?
When palpating the Bartholin glands during an external examination, at what approximate positions should the examiner apply pressure to assess for swelling or tenderness?
When palpating the Bartholin glands during an external examination, at what approximate positions should the examiner apply pressure to assess for swelling or tenderness?
What is the MOST important consideration when using lubricant on the speculum during a speculum examination?
What is the MOST important consideration when using lubricant on the speculum during a speculum examination?
During the speculum examination, if discharge is observed exuding from the duct opening of the Bartholin gland, what is the MOST appropriate next step?
During the speculum examination, if discharge is observed exuding from the duct opening of the Bartholin gland, what is the MOST appropriate next step?
When inspecting the urinary meatus during an external female genital examination, which of the following findings would warrant further investigation?
When inspecting the urinary meatus during an external female genital examination, which of the following findings would warrant further investigation?
To accurately describe an abnormality found during a chest examination, which approach combines both vertical and circumferential dimensions?
To accurately describe an abnormality found during a chest examination, which approach combines both vertical and circumferential dimensions?
A clinician needs to perform an emergency needle thoracostomy to relieve a tension pneumothorax. Which anatomical location is MOST appropriate for needle insertion?
A clinician needs to perform an emergency needle thoracostomy to relieve a tension pneumothorax. Which anatomical location is MOST appropriate for needle insertion?
Following intubation, a chest X-ray reveals the distal tip of the endotracheal tube at the level of the T6 vertebral body. What immediate action should be taken based on this finding?
Following intubation, a chest X-ray reveals the distal tip of the endotracheal tube at the level of the T6 vertebral body. What immediate action should be taken based on this finding?
While percussing the chest of a patient with suspected pneumonia, you identify an area of dullness. Which anatomical structure are you primarily assessing with this technique?
While percussing the chest of a patient with suspected pneumonia, you identify an area of dullness. Which anatomical structure are you primarily assessing with this technique?
During auscultation of a patient's lungs, you note decreased breath sounds at the base of the right lung. Which anatomical structure is MOST likely implicated in this finding?
During auscultation of a patient's lungs, you note decreased breath sounds at the base of the right lung. Which anatomical structure is MOST likely implicated in this finding?
Pectus excavatum is characterized by which of the following?
Pectus excavatum is characterized by which of the following?
Which of the following physical findings is MOST indicative of asymmetric chest expansion?
Which of the following physical findings is MOST indicative of asymmetric chest expansion?
Increased tactile fremitus is associated with all of the following conditions EXCEPT:
Increased tactile fremitus is associated with all of the following conditions EXCEPT:
In the context of vocal resonance abnormalities, which condition is MOST likely to cause decreased bronchophony?
In the context of vocal resonance abnormalities, which condition is MOST likely to cause decreased bronchophony?
Reduced diaphragmatic excursion can be observed in all of the following conditions EXCEPT:
Reduced diaphragmatic excursion can be observed in all of the following conditions EXCEPT:
During percussion of the chest, a dull sound is MOST likely to be percussed in which of the following conditions?
During percussion of the chest, a dull sound is MOST likely to be percussed in which of the following conditions?
Which adventitious breath sound is described as inspiratory, doesn’t clear with cough, and is associated with fibrosis?
Which adventitious breath sound is described as inspiratory, doesn’t clear with cough, and is associated with fibrosis?
Which adventitious breath sound is MOST likely associated with upper airway obstruction and is typically heard during inspiration?
Which adventitious breath sound is MOST likely associated with upper airway obstruction and is typically heard during inspiration?
A patient presents with hemoptysis. Prior to attributing the bleeding to the respiratory tract, which of the following represents the MOST crucial initial step in the diagnostic process?
A patient presents with hemoptysis. Prior to attributing the bleeding to the respiratory tract, which of the following represents the MOST crucial initial step in the diagnostic process?
A patient exhibits a cluster of symptoms including chronic cough, hemoptysis, night sweats, and unintentional weight loss. Considering these findings collectively, which of the following conditions should be given the HIGHEST priority in the differential diagnosis?
A patient exhibits a cluster of symptoms including chronic cough, hemoptysis, night sweats, and unintentional weight loss. Considering these findings collectively, which of the following conditions should be given the HIGHEST priority in the differential diagnosis?
In a patient with advanced COPD, the utilization of sternocleidomastoid (SCM) muscles during respiration is observed. What is the MOST clinically significant interpretation of this finding?
In a patient with advanced COPD, the utilization of sternocleidomastoid (SCM) muscles during respiration is observed. What is the MOST clinically significant interpretation of this finding?
A patient with obstructive lung disease is observed using pursed-lip breathing. Which of the following physiological mechanisms is MOST directly facilitated by this breathing technique?
A patient with obstructive lung disease is observed using pursed-lip breathing. Which of the following physiological mechanisms is MOST directly facilitated by this breathing technique?
Upon physical examination, an adult patient presents with a noticeable outward protrusion of the sternum and costal cartilages. This deformity is MOST accurately described as which of the following?
Upon physical examination, an adult patient presents with a noticeable outward protrusion of the sternum and costal cartilages. This deformity is MOST accurately described as which of the following?
Within what timeframe does the cardiovascular risk of heart attack and death from coronary heart disease reduce by approximately half after an individual ceases tobacco use?
Within what timeframe does the cardiovascular risk of heart attack and death from coronary heart disease reduce by approximately half after an individual ceases tobacco use?
According to the CDC's 2024 Adult Immunization Schedule, which of the following is the recommended COVID-19 vaccination protocol for an individual who received a complete initial series with a monovalent vaccine prior to the 2024-2025 formula update?
According to the CDC's 2024 Adult Immunization Schedule, which of the following is the recommended COVID-19 vaccination protocol for an individual who received a complete initial series with a monovalent vaccine prior to the 2024-2025 formula update?
For pregnant individuals in most of the continental United States, the RSV vaccine (Abrysvo™) is recommended during which gestational age range and timeframe?
For pregnant individuals in most of the continental United States, the RSV vaccine (Abrysvo™) is recommended during which gestational age range and timeframe?
According to the recommendations for RSV vaccination in adults aged 60 years and older, which approach BEST describes the decision-making process?
According to the recommendations for RSV vaccination in adults aged 60 years and older, which approach BEST describes the decision-making process?
If an individual quits smoking, approximately how long does it take for their lung cancer risk to be reduced to half of that of a continuing smoker?
If an individual quits smoking, approximately how long does it take for their lung cancer risk to be reduced to half of that of a continuing smoker?
When promoting influenza vaccination, what is the MOST accurate and comprehensive approach to patient education based on the provided content?
When promoting influenza vaccination, what is the MOST accurate and comprehensive approach to patient education based on the provided content?
What is the primary focus of health promotion and counseling as outlined in the provided materials?
What is the primary focus of health promotion and counseling as outlined in the provided materials?
A patient reports consistent menstrual cycles occurring every 18 days. Which term BEST describes this pattern?
A patient reports consistent menstrual cycles occurring every 18 days. Which term BEST describes this pattern?
If a patient has a history of three pregnancies, one ending in miscarriage at 18 weeks, and two resulting in live births at 39 weeks, how should their obstetric history be documented using the terms Gravidity and Parity?
If a patient has a history of three pregnancies, one ending in miscarriage at 18 weeks, and two resulting in live births at 39 weeks, how should their obstetric history be documented using the terms Gravidity and Parity?
A patient who has never been pregnant beyond viable gestational age is best described as:
A patient who has never been pregnant beyond viable gestational age is best described as:
A patient describes experiencing heavy menstrual bleeding lasting longer than usual, as well as intermittent spotting between periods. Which term accurately combines these symptoms?
A patient describes experiencing heavy menstrual bleeding lasting longer than usual, as well as intermittent spotting between periods. Which term accurately combines these symptoms?
A patient reports emotional, behavioral, and physical symptoms that appear consistently 2 days prior to menses for at least three consecutive cycles. According to the criteria, does this meet the criteria for premenstrual syndrome (PMS)?
A patient reports emotional, behavioral, and physical symptoms that appear consistently 2 days prior to menses for at least three consecutive cycles. According to the criteria, does this meet the criteria for premenstrual syndrome (PMS)?
A patient presents with vulvovaginal pruritus and reports a malodorous discharge. Which of the following diagnostic approaches will MOST effectively differentiate between common causes such as bacterial vaginosis, candidiasis, and trichomoniasis?
A patient presents with vulvovaginal pruritus and reports a malodorous discharge. Which of the following diagnostic approaches will MOST effectively differentiate between common causes such as bacterial vaginosis, candidiasis, and trichomoniasis?
A patient in their late 40s presents with complaints of menorrhagia and increasing dysmenorrhea. If secondary dysmenorrhea is suspected, which condition should be considered, requiring imaging for confirmation?
A patient in their late 40s presents with complaints of menorrhagia and increasing dysmenorrhea. If secondary dysmenorrhea is suspected, which condition should be considered, requiring imaging for confirmation?
Fill in the blank: ___________ is defined as excessive or prolonged menstrual bleeding occurring at regular intervals.
Fill in the blank: ___________ is defined as excessive or prolonged menstrual bleeding occurring at regular intervals.
A 30-year-old patient presents with postcoital bleeding. Which of the following conditions is MOST likely if the speculum examination reveals a friable cervix with contact bleeding?
A 30-year-old patient presents with postcoital bleeding. Which of the following conditions is MOST likely if the speculum examination reveals a friable cervix with contact bleeding?
Which of the following scenarios BEST represents the diagnostic criteria for primary amenorrhea?
Which of the following scenarios BEST represents the diagnostic criteria for primary amenorrhea?
What are clue cells associated with in gynecological health?
What are clue cells associated with in gynecological health?
Which of the following best describes the underlying mechanism of primary dysmenorrhea?
Which of the following best describes the underlying mechanism of primary dysmenorrhea?
Which of the following conditions is characterized by menstrual bleeding occurring at irregular intervals with excessive flow and duration?
Which of the following conditions is characterized by menstrual bleeding occurring at irregular intervals with excessive flow and duration?
Fill in the blank: ___________ is defined as the cessation of periods after they have been established.
Fill in the blank: ___________ is defined as the cessation of periods after they have been established.
A patient is complaining of acute pelvic pain. Which of the following is LEAST likely to be in the differential?
A patient is complaining of acute pelvic pain. Which of the following is LEAST likely to be in the differential?
A patient is currently pregnant. She has a history of one previous ectopic pregnancy (ended prior to 20 weeks), one stillbirth at 28 weeks, and two children born at 39 weeks. What is her obstetrical history using the GTPAL system?
A patient is currently pregnant. She has a history of one previous ectopic pregnancy (ended prior to 20 weeks), one stillbirth at 28 weeks, and two children born at 39 weeks. What is her obstetrical history using the GTPAL system?
A patient has been pregnant 4 times. Her first pregnancy resulted in twins born at 32 weeks, the second was a singleton born at 38 weeks, she had a miscarriage at 10 weeks, and her fourth pregnancy is ongoing. How would you document this using GTPAL?
A patient has been pregnant 4 times. Her first pregnancy resulted in twins born at 32 weeks, the second was a singleton born at 38 weeks, she had a miscarriage at 10 weeks, and her fourth pregnancy is ongoing. How would you document this using GTPAL?
A patient is noted to be G3P1102. Which of the following is the MOST accurate interpretation of this?
A patient is noted to be G3P1102. Which of the following is the MOST accurate interpretation of this?
A patient has a history that includes one miscarriage at 10 weeks gestation, a set of twins born at 39 weeks, and a singleton born at 30 weeks. Using the GTPAL documentation method, how should this be recorded?
A patient has a history that includes one miscarriage at 10 weeks gestation, a set of twins born at 39 weeks, and a singleton born at 30 weeks. Using the GTPAL documentation method, how should this be recorded?
Flashcards
Dysmenorrhea
Dysmenorrhea
Pain with menses, often with bearing down, aching, or cramping in the lower abdomen or pelvis.
Premenstrual Syndrome (PMS)
Premenstrual Syndrome (PMS)
A cluster of emotional, behavioral, and physical symptoms occurring 5 days before menses for three consecutive cycles.
Abnormal Uterine Bleeding
Abnormal Uterine Bleeding
Bleeding between menses; includes infrequent, excessive, prolonged, or postmenopausal bleeding.
Menorrhagia
Menorrhagia
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Metrorrhagia
Metrorrhagia
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Amenorrhea
Amenorrhea
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Abnormal Bleeding
Abnormal Bleeding
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PMS Symptom Cessation & Severity
PMS Symptom Cessation & Severity
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Vulvovaginal Symptoms
Vulvovaginal Symptoms
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Labia majora inflammation
Labia majora inflammation
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Bartholin gland abnormalities
Bartholin gland abnormalities
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Pubic hair distribution assessment
Pubic hair distribution assessment
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Clitoral abnormalities
Clitoral abnormalities
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Urinary meatus abnormalities
Urinary meatus abnormalities
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Vaginal introitus abnormalities
Vaginal introitus abnormalities
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Lubricant cautions for speculum exam
Lubricant cautions for speculum exam
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Best speculum lubrication
Best speculum lubrication
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Cervical Examination: Key Aspects
Cervical Examination: Key Aspects
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Bimanual Exam: Key Palpation Findings
Bimanual Exam: Key Palpation Findings
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Vaginal Wall Inspection: Key Observations
Vaginal Wall Inspection: Key Observations
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Pap Smear Sequence
Pap Smear Sequence
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Speculum Insertion Angle
Speculum Insertion Angle
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Vaginal Wall Inspection during Withdrawal
Vaginal Wall Inspection during Withdrawal
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Bimanual Exam: Finger Insertion
Bimanual Exam: Finger Insertion
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Locating Chest Abnormalities
Locating Chest Abnormalities
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Lung Lobes
Lung Lobes
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Tracheal Bifurcation Location
Tracheal Bifurcation Location
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Pleurae Types
Pleurae Types
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2nd Intercostal Space Use
2nd Intercostal Space Use
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Hemoptysis
Hemoptysis
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Tachypnea
Tachypnea
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Cyanosis
Cyanosis
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Barrel Chest
Barrel Chest
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Pectus Carinatum
Pectus Carinatum
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Smoking's Impact
Smoking's Impact
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Key Adult Immunizations
Key Adult Immunizations
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RSV Vaccine in Pregnancy
RSV Vaccine in Pregnancy
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RSV Vaccine (60+)
RSV Vaccine (60+)
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Promoting Immunizations
Promoting Immunizations
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COVID-19 Vaccination (Unvaccinated)
COVID-19 Vaccination (Unvaccinated)
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Tobacco Cessation
Tobacco Cessation
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Pectus Excavatum
Pectus Excavatum
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Kyphosis
Kyphosis
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Asymmetric Chest Expansion
Asymmetric Chest Expansion
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Increased Tactile Fremitus
Increased Tactile Fremitus
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Bronchophony (Increased)
Bronchophony (Increased)
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Reduced Diaphragmatic Excursion
Reduced Diaphragmatic Excursion
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Dull Percussion Note
Dull Percussion Note
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Rales
Rales
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Menarche
Menarche
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Primigravida
Primigravida
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Nullipara (Nullip)
Nullipara (Nullip)
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Miscarriage
Miscarriage
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Abnormal Dysmenorrhea
Abnormal Dysmenorrhea
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Causes of Dysmenorrhea
Causes of Dysmenorrhea
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Primary vs. Secondary Amenorrhea
Primary vs. Secondary Amenorrhea
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Vulvovaginal symptom types
Vulvovaginal symptom types
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HPI for GYN complaints
HPI for GYN complaints
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Gravidity
Gravidity
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Parity
Parity
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Term (T in TPAL)
Term (T in TPAL)
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Preterm (P in TPAL)
Preterm (P in TPAL)
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Abortions/miscarriages (A in TPAL)
Abortions/miscarriages (A in TPAL)
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Trichomoniasis Discharge
Trichomoniasis Discharge
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Clue Cells
Clue Cells
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Uterine Fibroids
Uterine Fibroids
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Cervicitis
Cervicitis
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Study Notes
Pulmonary Anatomy
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Vertical chest locations are found by counting the ribs/interspaces from landmarks such as the sternal angles
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Imaginary vertical lines on the chest helps locate findings on the circumference, examples including the midsternal line, the midclavicular line, the anterior-mid-posterior axillary lines, the scapular line, the vertebral line, and the costal angle.
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The trachea bifurcates into its main stem bronchi at the levels of the sternal angle anteriorly and around the T4 spinous process posteriorly.
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Lung field terminology; supraclavicular(above the clavicles), infraclavicular(below the clavicles), interscapular(between the scapulae), infrascapular(below the scapulae), apices of the lungs(uppermost portions), and bases of the lungs(lowermost portions).
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Topography:
- Vertebra prominens/C7 spinous process
- Clavicles
- Nipples
- Manubriosternal junction (angle of Louis)
- Suprasternal notch
- Costal angels
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Intercostal Muscle: used during accessory muscle use.
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Patients with COPD may exhibit Intercostal breathing
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Scalene: The scalene is also used during intercostal use when breathing. -This is shown with the sternocleidomastoid and causes them to become tired
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Lungs are divided into lobes by fissures.
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Left lung is divided into upper and lower lobes.
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Each lung is divided roughly in half by an oblique (major) fissure.
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The lungs are divided into upper, middle, and lower lobes; the minor fissure further divides the right lung.
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The right lung is divided into the upper, middle, and lower lobes divided by a horizontal fissure.
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The pleurae are serous membranes that cover the outer surface of each lung (visceral pleura) and the inner rib cage and the upper surface of the diaphragm (parietal pleura).
Anatomy Pearls
- The 4th intercostal space is for chest tube insertion.
- The vertebra prominens/C7 spinous process and clavicles are useful landmarks
- Neurovascular structures run along a rib's inferior margin; therefore needles and tubes should be placed just at the ribs superior margins.
- To place a chest x-ray, ensure the lower margin is at level T4.
- An insertion is needed for tension pneumothorax at the 2nd inters space.
Pulmonary Health History
Common Pulmonary Complaints
- When taking a patient history, note any complaints of chest pain, dyspnea, cough, wheezing, and hemoptysis
HPI/History of Present Illness
- History must be OLDCARTS
- Ask open-ended questions and avoid leading with direct concerns and diagnosis if able. For chest pain, ask, “Do you have any discomfort or unpleasant feelings in your chest?”
- Ask the patient to point to the location of the pain to establish a baseline.
- Dyspnea = a nonpainful but uncomfortable awareness of breathing that is inappropriate to the level of exertion
- Establish severity of daily activities and ask a broad question, such as, "Have you had any difficulty breathing?" Note: Heart Failure, Pneumonia, Pneumothorax, PE.
- Before using the term ‘hemopytsis,’ confirm that the source of bleeding is from the mouth, pharynx, or GI Tract
- Chest pain can arise from cardiac, vascular, gastrointestinal, musculoskeletal, or skin pathology, or it may be with anxiety. -Note: Pleuritic pain, costochondritis, Angina pectoris or myocardial infarction, Pericarditis, Dissection, or Gastrointestinal Reflux Disease.
- Ascertain if the cough is dry or of mucus
- Ask them to cough into a tissue; inspect it, and note its characteristics.
PMH
- Ask about thoracic trauma/surgery and dates of hospitalization for pulmonary disorders.
- Ask about use of O2/ventilation-assisting devices, and inquire about childhood asthma.
Family history should consider the following
- TB, cystic fibrosis, emphysema, allergy, asthma, malignancy and clotting disorders.
Social History Should Consider
- Employment, home environment, Tobacco use, Exposure to respiratory infections, regional and travel exposures, hobbies, drinking, drug use, exercise tolerance, and HIV risk factors,.
Identifying Respiratory Distress
- Respiratory Distress: tachypnea, cyanosis, pallor, diaphoresis, accessory muscle use, and breathing difficulties
Breathing Patterns
- No thoracic component is Pleurisy or chest wall pain.
- No abdominal component is due to an Acute abdomen
- Pursed lip breathing: Patients with obstructive lung disease have control.
Accessory Muscle Use
-Signs of usage include deeper breathing and intercostal retractions.
- Intercostal Muscle Usage: COPD Muscle Usage.
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Scalene use: means advanced COPD use
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SCM muscle: means impending intubation ( palapte only)
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Used Continuously
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Respiratory Inspections
- Thoracic diameter: chest shape/symmetry, chest wall movement, superficial venous patterns, prominence of ribs, * Anteroposterior and/ortransverse diameter, alongs with sternal Protrusion, and spinal deviation.
- A healthy anteroposterior (AP) diameter is less than to the transverse diameter -Increased AP diameter means barrel, which often implies COPD Thoracic Conditions-Deformity Pectus carinatum, Pectus excavatum, and Kyphosis are the most common deformations
Thoracic Conditions: Barrel Chest
- Increased AP diameter means barrel chest, which often implies COPD
- With large deformations and barrel in patients, approach 1:1 with large intercostal in the barrel
Fremitus-Palpation
- Palpation abnormalities with potential tactile Fremitus can originate consolidation, lobar pneumonia, heavy bronchial secretions, Segmental atelectasis, Pleural effusion, fibrosis or thickening, Massive pulmonary edema, and Hemothorax.
Resonance Vocal Examinations
-Increase Bronchophony: consolidation, caused by segmental Atelectasis, and when there is Pleural Effusion that increases the area.
- Reduce Bronchophony: Hyperinflation, Pneumothorax, COPD, and Asthma.
Percussion
Percussion tests the ability to locate the boundary between resonant lung tissue and dull structures below. Examples includes Large pleural effusion, Lobar pneumonia, COPD, Large pneumothorax)
- Reduce Excursion from conditions that descent: from the diaphragm, the Pulmonary COPD, Abdominal ascites/tumors, Superficial fracture ribs, tenderness, and/or diaphragm paralysis>
Breath Sounds
- Snoring/ gurgling: with disorders of the Nasopharynx, such as Hypertrophied tonsils (palatine tonsils), hypertrophied adenoids (pharyngeal tonsils), Nasal polyps, Foreign body, and Rhinitis.
- Pleural Friction Rub -> It will displease with the breath - If so, results in sounds/Raspy, dry, scratchy, (due to Pleural irritation & inflammation)
Wheezing
- caused by: FB Bronchitis Bronchiolitis Asthma-COPD-Emphysema)
Stridor
-Stridor will cause-Epiglottitis Laryngitis Retropharyngeal abscesses or FB (foreign body)
Rales:
- Rales: on Inspiration, no clear
- originates from-Fibrosis, Atelectasis, Pneumonia that forms( CHF)
- Rhonchi
- Can clear w a cough continuous on expiration
- This is heard frequently
Preventative Care
-
Smoking Cessation
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Encourage cessation, note the numbers, 19% of US adults smoke -Note key facts about the results
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note 5 A Model: Ask, Advise, Assess, Assist, Arrange
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-> Vaccination -Patient education, promote vaccination
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CDC Adult Immunization schedule, 2024:
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->RSV. - RSV vaccination (Abrysvo™™): pregnant at 32-36 weeks gestation or Age 60+
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Covid 19 Unvaccinated:1 dose of updated Formula Moderna or Pfizer-BioNTech vaccine/2-dose series of updated Novavax- Previously vaccinated: 1 dose a COVD dose is at least 8 weeks after the prior dose
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Pneumococcal Vaccine -Any adults- over 65 adults, and, having been a smoker or chronically sick, or immunocompromised.
• Influenza • Annual is encouraged all people over 6 months and over months of all people.
- -> CDC schedule, 2014
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This quiz covers various aspects of the menstrual cycle and gynecological health, including conditions like amenorrhea, dysmenorrhea, and premenstrual syndrome (PMS). It also addresses pelvic pain, urinary symptoms, and the evaluation of related health issues. The questions aim to test understanding of gynecological terminology and symptom identification.
