AHAFINALEXAMQUIZ
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Questions and Answers

What condition is characterized by the inward deviation of the eye?

  • Exotropia
  • Hypotropia
  • Esotropia (correct)
  • Hypertropia
  • Which condition is most commonly caused by viral or bacterial infections in the lacrimal gland?

  • Sjögren Syndrome
  • Acute dacryoadenitis (correct)
  • Chronic dacryoadenitis
  • Lacrimal gland tumors
  • What are the symptoms of lacrimal gland enlargement?

  • Itchy eyes and tearing
  • Gradual loss of vision and headache
  • Redness and swelling of the gland, eye pressure, and diplopia (correct)
  • Color vision changes and photophobia
  • Which of the following conditions is associated with impaired drainage of tears?

    <p>Nasolacrimal duct obstruction (A)</p> Signup and view all the answers

    What is the common feature of thyroid eye disease?

    <p>Protrusion of the eyeball (A)</p> Signup and view all the answers

    What type of dacryoadenitis can be caused by non-infectious inflammatory disorders?

    <p>Chronic dacryoadenitis (A)</p> Signup and view all the answers

    A patient presents with dry eyes and gritty sensation. Which condition is indicated?

    <p>Sjögren Syndrome (A)</p> Signup and view all the answers

    What causes thyroid eye disease?

    <p>Autoreactive T lymphocytes (A)</p> Signup and view all the answers

    What is a common symptom of carpal tunnel syndrome?

    <p>Numbness in the thumb (B)</p> Signup and view all the answers

    How can a splint help alleviate symptoms of carpal tunnel syndrome?

    <p>By preventing wrist movement (C)</p> Signup and view all the answers

    What is the primary purpose of corticosteroid injections for carpal tunnel syndrome?

    <p>To relieve pressure on the median nerve (B)</p> Signup and view all the answers

    What does the McMurray test help diagnose?

    <p>Torn meniscus in the knee (C)</p> Signup and view all the answers

    Which treatment option is least invasive for carpal tunnel syndrome?

    <p>Extracorporeal Shock Wave Therapy (A)</p> Signup and view all the answers

    What should be avoided to help manage carpal tunnel syndrome symptoms?

    <p>Resting hands periodically (B)</p> Signup and view all the answers

    Which method can enhance recovery for carpal tunnel syndrome?

    <p>Stretching and strengthening exercises (D)</p> Signup and view all the answers

    What effect does endoscopic repair of carpal tunnel syndrome have on recovery time compared to open repair?

    <p>Patients usually return to work sooner (D)</p> Signup and view all the answers

    What does a positive McMurray test indicate?

    <p>A compromised meniscus (D)</p> Signup and view all the answers

    Which maneuver is performed to assess the anterior cruciate ligament during the drawer test?

    <p>Pulling the patient's leg towards the examiner while sitting on their foot (A)</p> Signup and view all the answers

    Which of the following is a common characteristic of scoliosis?

    <p>It presents as an abnormal S-shaped or C-shaped curve (D)</p> Signup and view all the answers

    What does the posterior drawer test assess?

    <p>Integrity of the posterior cruciate ligament (C)</p> Signup and view all the answers

    What potential indicator might accompany a positive McMurray test?

    <p>Pain, snapping, or audible clicking (D)</p> Signup and view all the answers

    What is the common symptom of Chadwick's sign during pregnancy?

    <p>Bluish or purplish discoloration of reproductive tissues (B)</p> Signup and view all the answers

    What is the primary method used to diagnose scoliosis?

    <p>Physical examination and X-rays (D)</p> Signup and view all the answers

    In scoliosis, the term 'idiopathic' refers to:

    <p>An unknown cause (B)</p> Signup and view all the answers

    What is the main purpose of the Lachman maneuver?

    <p>To evaluate the integrity of the anterior cruciate ligament (C)</p> Signup and view all the answers

    What does a positive result indicate during the Lachman maneuver?

    <p>The tibia translates anteriorly more than 2 mm (A)</p> Signup and view all the answers

    Which statement accurately describes fibroadenomas?

    <p>They are usually painless and have a well-defined border (A)</p> Signup and view all the answers

    In which age group are fibroadenomas most commonly found?

    <p>Women between 14 and 35 (C)</p> Signup and view all the answers

    What is the most likely cause of fibrocystic breast changes?

    <p>Hormonal changes during menstruation (D)</p> Signup and view all the answers

    Which symptom is NOT commonly associated with fibrocystic breast changes?

    <p>Fever (D)</p> Signup and view all the answers

    What may be recommended if a fibroadenoma continues to grow?

    <p>Surgical removal or cryoablation (A)</p> Signup and view all the answers

    What is the maximum acceptable laxity found in a normal Lachman maneuver result?

    <p>No more than 6–8 mm (B)</p> Signup and view all the answers

    Which supportive therapy is commonly recommended for improving mobility?

    <p>Physiotherapy (B)</p> Signup and view all the answers

    What is a potential surgical intervention for severe arthritis complications?

    <p>Knee or hip replacement (A)</p> Signup and view all the answers

    Which of the following can indicate a diagnosis of bacterial vaginosis?

    <p>Presence of clue cells in vaginal fluid (D)</p> Signup and view all the answers

    Which treatment is NOT recommended for trichomoniasis?

    <p>Acyclovir (D)</p> Signup and view all the answers

    What is the characteristic vaginal discharge associated with Trichomonas infection?

    <p>Yellow and frothy (A)</p> Signup and view all the answers

    What is the primary diagnostic test for bacterial vaginosis?

    <p>Gram Stain (B)</p> Signup and view all the answers

    Which of the following hormones is responsible for regulating calcium and phosphate levels in the blood?

    <p>Calcitonin (C)</p> Signup and view all the answers

    What symptom is commonly associated with bacterial vaginosis during the 'whiff test'?

    <p>Fishy odor (B)</p> Signup and view all the answers

    What is the monotherapy treatment for gonorrhea in adults?

    <p>500 mg of ceftriaxone administered intramuscularly (D)</p> Signup and view all the answers

    Which of the following symptoms is NOT associated with a vaginal yeast infection?

    <p>Increased vaginal discharge (D)</p> Signup and view all the answers

    What is one of the main risk factors for testicular cancer?

    <p>Family history of testicular cancer (B)</p> Signup and view all the answers

    What is a common characteristic finding in the assessment of testicular cancer?

    <p>Painless testicular mass (D)</p> Signup and view all the answers

    Which diagnostic test is considered the gold standard for detecting gonorrhea?

    <p>NAAT test (C)</p> Signup and view all the answers

    Which antifungal medication is typically used in a single oral dose to treat vaginal yeast infections?

    <p>Fluconazole (C)</p> Signup and view all the answers

    What is a significant long-term complication of untreated gonorrhea?

    <p>Pelvic inflammatory disease (A)</p> Signup and view all the answers

    Which of the following populations has the lowest risk of developing testicular cancer?

    <p>Black males (D)</p> Signup and view all the answers

    Flashcards

    Esotropia

    Inward deviation of the eye.

    Exotropia

    Outward deviation of the eye.

    Hypertropia

    Upward deviation of the eye.

    Hypotropia

    Downward deviation of the eye.

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    Dacryoadenitis

    Inflammation of the lacrimal gland.

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    Dry Eye

    Red eye with gritty sensation due to impaired tear secretion.

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    Nasolacrimal Duct Obstruction

    Blocked tear drainage pathway.

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    Thyroid Eye Disease

    Eye changes caused by an autoimmune response involving the thyroid gland.

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    Carpal Tunnel Syndrome (CTS)

    A condition where the median nerve in the wrist is compressed, causing numbness, tingling, and pain in the hand and forearm.

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    CTS Symptoms

    Numbness, tingling, burning in the thumb, index, middle, and ring fingers; pain or tingling up the forearm; weakness and clumsiness in the hand; dropping things; shock-like sensations.

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    Wrist Splint (CTS)

    A device that immobilizes the wrist to reduce nerve compression and ease CTS symptoms, often worn at night.

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    McMurray Test

    A physical exam used to diagnose a torn meniscus in the knee.

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    Meniscus Tear

    A tear in the cartilage that cushions the knee joint.

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    CTS Treatment: Surgery

    Cutting a ligament in the wrist to relieve pressure on the median nerve.

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    CTS Treatment: Medications

    Anti-inflammatory or corticosteroid medications to reduce swelling and pain.

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    CTS Treatment: Exercises

    Stretching and strengthening exercises to improve symptoms.

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    Positive McMurray Test

    Indicates a probable meniscus tear, showing symptoms like pain, snapping, clicking, or locking.

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    Anterior Drawer Test

    Examines the anterior cruciate ligament (ACL) in the knee, for possible tears.

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    Posterior Drawer Test

    Evaluates the posterior cruciate ligament (PCL) in the knee for possible tears.

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    Scoliosis

    A sideways curve in the spine, often S-shaped or C-shaped.

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    Idiopathic Scoliosis

    Scoliosis with an unknown cause.

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    Chadwick's Sign

    Bluish/purplish discoloration of the vulva/vagina/cervix, during pregnancy.

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    Ankle Drawer Test

    Checks for instability in the ankle by examining the lateral ligaments.

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    Lachman Maneuver

    A physical exam used to assess the integrity of the Anterior Cruciate Ligament (ACL) in the knee. It involves flexing the knee to 20-30 degrees, stabilizing the thigh, and pulling the tibia anteriorly.

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    Positive Lachman Maneuver

    Indicates an ACL injury. The tibia translates anteriorly more than 2 mm compared to the uninjured knee, or there is a soft or mushy end point to the movement.

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    Normal Lachman Maneuver

    Indicates a healthy ACL. There should be no more than 6-8 mm of laxity.

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    Fibroadenoma

    A non-cancerous breast tumor characterized by a solid, firm, rubbery lump. It's usually painless, round, well-defined, and moves easily under the skin.

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    Fibroadenoma Cause

    Fibroadenomas develop from the lobules of the breast where glandular tissue and ducts grow excessively forming a solid lump.

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    Prevalence of Fibroadenomas

    Most common in women aged 14-35 but can occur in any age group. They are less prevalent in post-menopausal women as they shrink with declining hormone levels.

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    Fibrocystic Breast Changes

    A common condition causing non-cancerous changes in breast tissue. Symptoms include lumps or cysts, swelling, discomfort, tenderness, pain, itching, sensitive nipples, and changes in breast texture.

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    Cause of Fibrocystic Breast Changes

    Hormonal changes during menstruation are believed to trigger the thickening of breast tissue (fibrosis) and the development of fluid-filled cysts.

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    Supportive Therapies

    Treatments aiding in managing osteoarthritis symptoms. Examples include physiotherapy, occupational therapy, and devices like shoe inserts or walking sticks.

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    Osteoarthritis Surgery

    Surgical procedures for osteoarthritis complications like broken bones, severe joint damage, or deformities. Examples include hip or knee replacements.

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    Calcium & Vitamin D for Osteoarthritis

    Supplements recommended for osteoarthritis to ensure adequate calcium and vitamin D intake. Vitamin D can be obtained from sunlight, oily fish, or supplements like fish oil.

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    Calcitonin (for Osteoarthritis)

    A hormone produced by the thyroid gland that regulates calcium and phosphate levels in the blood, and promotes new bone formation.

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    Ductal Carcinoma

    A type of breast cancer originating from the epithelial lining of the ducts.

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    Lobular Carcinoma

    A type of breast cancer developing in the glandular tissue of the lobes.

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    Fibrosis in Breast Cancer

    Scar tissue formation as breast cancer progresses.

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    Bacterial Vaginosis (BV)

    A common vaginal infection caused by an imbalance of bacteria. Characterized by thin white discharge, clue cells, vaginal pH>4.5, and a fishy odor.

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    Gonorrhea

    A sexually transmitted infection caused by the bacteria Neisseria gonorrhoeae. It can affect the genitals, rectum, and throat. Symptoms include painful urination, vaginal discharge, and bleeding between periods. While up to 80% of women and 40% of men with gonorrhea don't show symptoms, it can lead to serious complications like infertility and pelvic inflammatory disease.

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    Gonorrhea Treatment

    Gonorrhea is treated with a single intramuscular injection of ceftriaxone 500mg.

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    Vaginal Yeast Infection

    A common infection caused by an overgrowth of the fungus Candida albicans. It can cause itching, burning, a thick white discharge, and pain during sex.

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    Treating Yeast Infections

    Antifungal medications are used to treat yeast infections. These can be taken orally (like fluconazole) or applied topically to the vaginal area.

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    Testicular Cancer

    A malignant tumor that develops in the testicles. Most cases are germ cell tumors, while a smaller percentage are non-germ cell tumors.

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    Testicular Cancer Risk Factors

    Risk factors for testicular cancer include a history of cryptorchidism (undescended testicles), family history of testicular cancer, and previous testicular cancer. White men are more at risk than Black men.

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    Testicular Cancer Symptoms

    Common symptoms include a painless lump in the testicle, swelling, and discomfort. The affected testicle may feel harder than usual.

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    Testicle Self-Exams

    Regular self-exams are recommended, especially for men with risk factors, to detect testicular cancer early. Early detection increases the chances of a successful cure.

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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.

    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

    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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