Podcast
Questions and Answers
What condition is characterized by the inward deviation of the eye?
What condition is characterized by the inward deviation of the eye?
Which condition is most commonly caused by viral or bacterial infections in the lacrimal gland?
Which condition is most commonly caused by viral or bacterial infections in the lacrimal gland?
What are the symptoms of lacrimal gland enlargement?
What are the symptoms of lacrimal gland enlargement?
Which of the following conditions is associated with impaired drainage of tears?
Which of the following conditions is associated with impaired drainage of tears?
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What is the common feature of thyroid eye disease?
What is the common feature of thyroid eye disease?
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What type of dacryoadenitis can be caused by non-infectious inflammatory disorders?
What type of dacryoadenitis can be caused by non-infectious inflammatory disorders?
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A patient presents with dry eyes and gritty sensation. Which condition is indicated?
A patient presents with dry eyes and gritty sensation. Which condition is indicated?
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What causes thyroid eye disease?
What causes thyroid eye disease?
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What is a common symptom of carpal tunnel syndrome?
What is a common symptom of carpal tunnel syndrome?
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How can a splint help alleviate symptoms of carpal tunnel syndrome?
How can a splint help alleviate symptoms of carpal tunnel syndrome?
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What is the primary purpose of corticosteroid injections for carpal tunnel syndrome?
What is the primary purpose of corticosteroid injections for carpal tunnel syndrome?
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What does the McMurray test help diagnose?
What does the McMurray test help diagnose?
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Which treatment option is least invasive for carpal tunnel syndrome?
Which treatment option is least invasive for carpal tunnel syndrome?
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What should be avoided to help manage carpal tunnel syndrome symptoms?
What should be avoided to help manage carpal tunnel syndrome symptoms?
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Which method can enhance recovery for carpal tunnel syndrome?
Which method can enhance recovery for carpal tunnel syndrome?
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What effect does endoscopic repair of carpal tunnel syndrome have on recovery time compared to open repair?
What effect does endoscopic repair of carpal tunnel syndrome have on recovery time compared to open repair?
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What does a positive McMurray test indicate?
What does a positive McMurray test indicate?
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Which maneuver is performed to assess the anterior cruciate ligament during the drawer test?
Which maneuver is performed to assess the anterior cruciate ligament during the drawer test?
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Which of the following is a common characteristic of scoliosis?
Which of the following is a common characteristic of scoliosis?
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What does the posterior drawer test assess?
What does the posterior drawer test assess?
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What potential indicator might accompany a positive McMurray test?
What potential indicator might accompany a positive McMurray test?
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What is the common symptom of Chadwick's sign during pregnancy?
What is the common symptom of Chadwick's sign during pregnancy?
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What is the primary method used to diagnose scoliosis?
What is the primary method used to diagnose scoliosis?
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In scoliosis, the term 'idiopathic' refers to:
In scoliosis, the term 'idiopathic' refers to:
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What is the main purpose of the Lachman maneuver?
What is the main purpose of the Lachman maneuver?
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What does a positive result indicate during the Lachman maneuver?
What does a positive result indicate during the Lachman maneuver?
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Which statement accurately describes fibroadenomas?
Which statement accurately describes fibroadenomas?
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In which age group are fibroadenomas most commonly found?
In which age group are fibroadenomas most commonly found?
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What is the most likely cause of fibrocystic breast changes?
What is the most likely cause of fibrocystic breast changes?
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Which symptom is NOT commonly associated with fibrocystic breast changes?
Which symptom is NOT commonly associated with fibrocystic breast changes?
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What may be recommended if a fibroadenoma continues to grow?
What may be recommended if a fibroadenoma continues to grow?
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What is the maximum acceptable laxity found in a normal Lachman maneuver result?
What is the maximum acceptable laxity found in a normal Lachman maneuver result?
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Which supportive therapy is commonly recommended for improving mobility?
Which supportive therapy is commonly recommended for improving mobility?
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What is a potential surgical intervention for severe arthritis complications?
What is a potential surgical intervention for severe arthritis complications?
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Which of the following can indicate a diagnosis of bacterial vaginosis?
Which of the following can indicate a diagnosis of bacterial vaginosis?
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Which treatment is NOT recommended for trichomoniasis?
Which treatment is NOT recommended for trichomoniasis?
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What is the characteristic vaginal discharge associated with Trichomonas infection?
What is the characteristic vaginal discharge associated with Trichomonas infection?
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What is the primary diagnostic test for bacterial vaginosis?
What is the primary diagnostic test for bacterial vaginosis?
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Which of the following hormones is responsible for regulating calcium and phosphate levels in the blood?
Which of the following hormones is responsible for regulating calcium and phosphate levels in the blood?
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What symptom is commonly associated with bacterial vaginosis during the 'whiff test'?
What symptom is commonly associated with bacterial vaginosis during the 'whiff test'?
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What is the monotherapy treatment for gonorrhea in adults?
What is the monotherapy treatment for gonorrhea in adults?
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Which of the following symptoms is NOT associated with a vaginal yeast infection?
Which of the following symptoms is NOT associated with a vaginal yeast infection?
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What is one of the main risk factors for testicular cancer?
What is one of the main risk factors for testicular cancer?
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What is a common characteristic finding in the assessment of testicular cancer?
What is a common characteristic finding in the assessment of testicular cancer?
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Which diagnostic test is considered the gold standard for detecting gonorrhea?
Which diagnostic test is considered the gold standard for detecting gonorrhea?
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Which antifungal medication is typically used in a single oral dose to treat vaginal yeast infections?
Which antifungal medication is typically used in a single oral dose to treat vaginal yeast infections?
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What is a significant long-term complication of untreated gonorrhea?
What is a significant long-term complication of untreated gonorrhea?
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Which of the following populations has the lowest risk of developing testicular cancer?
Which of the following populations has the lowest risk of developing testicular cancer?
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Study Notes
Health Assessment Exam #1 Blueprint
-
Know the difference between hypertropia, exotropia, esotropia, and hypotropia.
- Esotropia (inward deviation)
- Exotropia (outward deviation)
- Hypertropia (upward deviation)
- Hypotropia (downward deviation)
-
Know the difference between Lacrimal gland enlargement, Dryness of the eyes, Nasolacrimal duct obstruction, and Thyroid eye disease.
- Lacrimal gland enlargement (dacryoadenitis) can be caused by infections, inflammation, or autoimmune diseases.
- Acute dacryoadenitis is most common in children and young adults, often caused by viral or bacterial infections (e.g., mumps, Epstein-Barr virus, staphylococcus, gonococcus) and causes tenderness, redness, and swelling of the gland, potentially causing the eyelid to droop.
- Chronic dacryoadenitis can be caused by inflammatory disorders like thyroid eye disease, sarcoidosis, or orbital pseudotumor.
- Lacrimal gland tumors, including pleomorphic adenomas (can cause diplopia and limited ocular motility) and lymphomas (more common in patients over 60, but can also occur in children)
- Sjögren Syndrome is an autoimmune disorder causing progressive degeneration of the lacrimal glands, leading to symptoms like pressure on the eye and distorted vision.
- Treatment for lacrimal gland swelling varies based on the cause.
- Lacrimal gland enlargement (dacryoadenitis) can be caused by infections, inflammation, or autoimmune diseases.
Patient Encounters
- What is therapeutic communication and special consideration for blind/low-vision patients and patients hard of hearing?
- For blind/low-vision patients: Establish contact by shaking hands, explain name/role, and verbally orient to the room. Encourage glasses if worn, and explain verbally with gestures.
- For hearing impaired patients: Establish contact and find out preferred method of communication (e.g., ASL). Encourage use of hearing aids.
Effective Patient Encounters
- How do we establish an effective patient encounter?
- Step 1: Initiating the encounter
- Setting the stage/preparation
- Greeting the patient and establishing initial rapport
- Step 2: Gathering information
- Initiating information gathering
- Exploring patient's perspective of illness
- Step 3 and 4: Performing the physical exam, explaining and planning
- Provide correct information and plans of actions
- Decide and Negotiate the plan of action
- Shared decision making
- Step 5: Closing the encounter
- Step 1: Initiating the encounter
Clues to the Patient's Perspective on Illness
- Direct statement(s) by the patient about feelings, effects, and understanding.
- Expression of feelings or concerns and attempts to explain illness.
- Speech clues (repetition, pauses, sharing a personal story) to show the person's understanding and perspective on illness.
- Behavioral clues that indicate unmet needs, such as reluctance to a second opinion, an early return, or a lack of acceptance to the situation.
Physical Exam
- General (orientation, mood, etc.)
- Eyes (pupils, conjuctiva, sclera, acuities)
- Head, Ears, Nose, and Throat (HENT)
- Nerves (I-XII)
- Neck
- Cardiovascular
- Gastrointestinal
- Musculoskeletal
- Neurological/psychiatric
- integumentary
- Genitourinary
- Other important parts to check
Causes of Fatigue
- Fatigue is a common symptom of depression and anxiety, but consider infectious, endocrine, adrenal, heart failure, COPD/CKD, anemia, electrolyte imbalance, malignancy, nutritional deficits and medications side effects.
- Fatigue is a normal response to hard work, sustained stresses, or grief.
Hypothyroidism vs Hyperthyroidism
- Hypothyroidism: low production of thyroid hormone, characterized by fatigue, weight gain, cold intolerance, dry skin and hair
- Hyperthyroidism: excessive production of thyroid hormone, characterized by weight loss, nervousness, heat intolerance, and rapid pulse
Alzheimer's Disease
- Consists of: Clear evidence of cognitive decline in two or more cognitive domains, steady progressive decline in cognition without extended plateaus, and no other diseases/conditions.
- Alertness and attention are preserved, memory difficulties include repetition of questions, losing objects, or confusion while performing tasks such as shopping
- Late stages include reduced judgement and disorientation, progressing to aphasia, problems with daily life activities.
No Cure for Alzheimer's Disease
- Treatments include cholinesterase inhibitors (increase acetylcholine), memantine(blocks glutamate), and immunotherapy drugs (reduce amyloid plaques)
Other Common Drugs and Overdose
- Opioids (morphine, oxycodone), and fentanyl are commonly overdosed.
- Marijuana, cocaine, and psychotherapeutic are also common stimulants to overdose
Important Foods to Reduce Risk of Cardiovascular Risks
- Vegetables: leafy greens, carrots, broccoli
- Fruits: apples, bananas, oranges, grapes, prunes
- Whole grains: oatmeal, brown rice, grain bread, tortillas
- Low-fat dairy: milk, cheese, yogurt
- High-protein foods: fish (high in omega-3 fatty acids like salmon, tuna), lean meat, turkey
- Eggs, nuts, seeds, soy products, legumes (beans, lentils)
- Oils and foods high in monounsaturated and polyunsaturated fats (canola, corn, olive, safflower, sunflower, and soybean)
- Nuts, seeds, and soy products (tofu)
- Legumes (kidney beans, lentils, chickpeas, black-eyed peas, and lima beans)
- Oils: Canola, corn, olive, safflower, sesame, sunflower, and soybean oils (not coconut or palm oil)
- Nuts: Walnuts, almonds, pine nuts
- Nut butter
- Salmon, trout
- Seeds: sesame, sunflower, pumpkin, flax
- Avocados
Common Breath Odor (Halitosis)
- Poor oral hygiene, tobacco smoking, plaque retention on teeth, dentures, periodontal disease
Clues to the Patient's Perspective on Illness
- Direct statements, feelings, attempts to understand, speech clues, and behavioral clues
Health Disparities
- At the patient level: Ask patient about social challenges, guide to resources to access benefits/support services
- At the practice level: offer culturally safe care, use patient care navigators
- At the community level: partner with local organizations/public health agencies
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